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OPHTE# Harnett County Department of Public Health 21 1 6 6 PERMIT # > Operation Permit New Installation X Septic Tank ❑ Repair )K Nitrification Line ❑ Expansion PROPERTY LOCATION: Name: (owner) ?-giL N~ Sys SUBDIVISION LOT # 3 _ System Installer: W P~~ _s Registration # Basement with plumbing: ❑ Garage Number of Bedrooms 3 Type of Water Supply: ❑ Community Public ❑ Well Distance from well S O~ feet System Type: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. harm nas ueen imtanea in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization. Cc r'' 2 t PERMIT CONDITIONS- 0 R s ' ~4 ~ 02,D.~asikt~ ~AsEr.~Nt 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 ca maintenance and reporting. Following are the specifications for the sewage disposal system on the above captioned property. Type of system: X Conventional ❑ Other Subsurface _.fh~pf exact length Drainage Field ditches ~ of each ditch 9,40 feet French Drain Required: I- J irtwj`r" fuat, Septic Tank: X60 Q gallons Pump Tank: gallons width of depth of ditches 2 feet ditches 35-40 inches Authorized State Agent ~ - Date i a% r,,,. ~ ,+1 .p ? = 9Or Wis.