OPHTE# 07-j-- Harnett County Department of Public Health 2 0 71 2
PERMIT # as_(-/.S_ Operation Permit
O /New Installation P Septic Tank ❑ Repair 2/"Nitriffcation Line ❑ Expansion
PROPERTY LOCATION: awfe,tice_
Name: (owner) S-t(., V_ SUBDIVISION _C' F•~ n o.ww,~ f~, LOT #
System Installer /t GJ fer c~~-c 1,iVk_ S_.-V;te Registration #
Basement with plumbing: ❑ Garage ❑ Number of Bedrooms •-3
Type of Water Supply: ❑ Community le Public ❑ Well Distance from well feet
System Type: ~r 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.
um sptem nas oeen imraueo in compoance wan appocaoie norm Laronna beneral statutes, nines for )ewage treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization
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PERMIT CONDITIONS:
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1. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
Following are the specifications for the sewa Isposal system on t above captioned property. %
Type of system: ❑ Conventional Other , -P- I' Septic Tank: gallons Pump Tank: gallons
Subsurface No. of exact lengt width of depth of
Drainage field ditches of each ditch 02 feet ditches 3 feet ditches l6 inches
French Drain Required: Linear feet
Authorized State Agent'.,,, Date
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FROM :MAPLES SEPTIC TANK SERVICE FAX NO. :9192583914 Sep. 30 2009 03:50PM P2
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