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OPHTE#09-5=aaoa~ Harnett County Department of Public Health 2 0 8 0 8 PERMIT # D6t-11-1 Operation Permit X New Installation X Septic Tank ❑ Repairx Nitrification Line ❑ Expansion PROPERTY LO(ATION: \nf t>-tr 1-vt- RS Name: (owner) ip-) N L-L C. -P„ L"- V ion SUBDIVISION C- 0 o,.ts LOT # L~741 System Installer: So •v ES S tAn % 4 S E a.-g Registration # Basement with plumbing: ❑ Garage Number of Bedrooms _ t Type of Water Supply: ❑ Community Public ❑ Well Distance from well 10 © feet System Type: ZC. h Types V and VI Systems expire in 5 years. (In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal. qn-' nee uCCll mfwneu in compliance with applicable north t.arobna General Statutes, Rules for Sewage Treatment and Disposal and all conditions of the Improvement Permit and Construction Authorization. Cbt,p fir! RG6 2-0 Ctt~s~,~,.r~ _ t5"sE~BP,~x 1 as% '7~a~ar a I6t ti I I r.iA"x 43' I I t aE T 1 ~2-° 3C~ , vFRMIT fnNnITIALK- I. Performance: II. Monitoring: III. Maintenance: IV. Operation: V. Other. System shall perform in accordance with Rule .1961. As required by Rule .1961. As required by Rule .1961. Other. Subsurface system operator required? Yes ❑ No~ If yes, see attached sheet for additional operation conditions, maintenance and reporting. Following are the specifications for the sewage disposal system on the above captioned property. Type of system: 0 Conventional ❑ Other Septic Tank: f d o 0 gallons Pump Tank gallons Subsurface No. of exact length width of depth of Drainage field ditches `of each ditch 3J.0 feet ditches 3 feet ditches inches French Drain Reouired: fp.A Authorized State Age Date 'N 4k Y sJ ~ t r ~ryr-~ r '710 S 44 * FN yam' .per i y • F alt'- ~ la~ Y } ~ i. ` r } to 1 7 r ~ 4 t : r Yr Ki 'a o~.-s-~,aoa~ ~,F F y C F, d t t ~ r