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OPHTE# 0i -5-ate,-~ Harnett County Department of Public Health 21342 PERMIT # 2570 Operation Permit New Installation L Septic Tank ❑ Repair Nitrification Line ❑ Expansion PROPERTY LOCATION: W ALL L-yc,As VD Name: (owner) G ~Nooor+ SUBDIVISION C ES1_,sr,. Q ass LOT # 41 System Installer: SoNFs S.L \<us-catt~„~etJ Registration # Basement with plumbing: ❑ Garage 'X Number of Bedrooms 9 Type of Water Supply: ❑ Community Public ❑ Well Distance from well tcti C7 feet System Type: 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. mis 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. l© V I I 9 b i 1 ' z t5~ v 0 l3~ 3K5 5' D R r C 3S ~ QufJ ~ c,p, G,c nrnwr ~nun~r~nur 1 LI1I111 W11UIIIVI1J. 1. 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 ❑ NOX 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: X Conventional ❑ Other Subsurface No. of exact length Drainage Field ditches of each ditch feet French Drain Required: Septic Tank: I op o gallons Pump Tank: gallons width of depth of ditches 3 feet ditches aLk-~4 inches Authorized State Agent ZL\Ns Date r i 3s ~ • 1 a ~a I t R~ I I f~ W I O .d ~ e