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OPHTE# ~;3.5-- a-30~ Harnett County Department of Public Health 21 13 9 PERMIT # Operation Permit E New Installation P leptic Tank ❑ Repair Ef" Nitrification Line ❑ Expansion PROPERTY LOCATION: ~r©> zlwcy %d. Name: (owner) ffe,rs.y /4Q,k' SUBDIVISION LOT # System Installer: A/ r c I~ fA Registration # Basement with plumbing: ❑ Garage ❑ Number of Bedrooms 1.7 Type of Water Supply: ❑ Community ❑ Public 0 "Well Distance from well feet System Type: L,L b 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. ims system nas seen mstauea in compuance wim appluDie norm larohna General statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization. t ~ ~ AJ ~n i S s'cn e~ t0 1_u o1°tf cl ~r Pc- v.3 sct - r N-rAr A~-F i f> ~Q n~ 4 t ,4 I ; r'.lx t ~ 1 tf , 14 # rtninll LIJINUIIlUNY 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: Qi( V. Other. T 47-a 9 G - eo ' Following are the spef iications for the sewage disposal system on the above captioned property. Type of system: K Conventional ❑ Other Subsurface No. of exact length Drainage Field ditches of each ditch `00 feet Septic Tank: /00 U gallons Pump Tank: width of depth of ditches feet ditches gallons /8 inches French Drain Required: Linear feet Authorized State Agent z- l` Date a~fd 'rQ'V "e d.