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OPHTE# cs~--~,~a Harnett County Department of Public Health 21 2 6 4 PERMIT # Operation Permit New Installation X Septic Tank ❑ Repair)< Nitrification Line ❑ Expansion PROPERTY LOCATION: N Name: (owner) C.u Ma~c,g* sa ~1or,C 5 Lr~ SUBDIVISION M sczE ~alaNc.>r ~s~c`1 LOT # Co3 System Installer: `Tc~ 4~cw~ Registration # Basement with plumbing: ❑ Garage 'IX Number of Bedrooms Type of Water Supply: ❑ Community Public ❑ Well Distance from well MO feet System Type:- 1 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. ~ Pu«,e wov, anal t'~uc~t sN~Q.Gfn,~ 5a D Q 45~ v G 1-75 S u na.% oGE O~ PERMIT CONDITIONS: 1. Performance: System shall perform in accordance with Rule .1961. 11. Monitoring: As required by Rule .1961. 111. Maintenance: As required by Rule .1961. Other. Subsurface system operator required? Yes ❑ NoA If yes, see attached sheet for additional operation conditions, maintenance and reporting. IV. Operation: V. Other. Following are the specifications for the sewage disposal system on the above captioned~roperty. ~l C Required: r t Authorized State Agent 5 Date 3110 This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization )1`1 Type of system: El Conventional Other hArnsG2 v.c c_ti1 Septic Tank: ~~od gallons Pump Tank: L000 gallons Subsurface No. of exact length width of depth of Drainage Field ditches of each ditch feet ditches J feet ditches inche French Drain s F ~w t 1 v ~ ~ ry IV g- 3 L e 3AF P4 Zt t lit ii w8 t= ~ Ij~r ~ u}