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OPHTE#S O-s--D (-y) Harnett County Department of Public Health 21 3 51 PERMIT # Operation Permit New Installation Septic Tank El Repair Nitrification Line El Expansion PROPERTY LOCATION: N L-y \,4 CL Name: (owner) Ec` ~ Cvn,r.~~i6S SUBDIVISION r" 't7 LOT # 15~j- System Installer: Q-v ~ s 2~C-`Grt Registration # Basement with plumbing: ❑ Garage Number of Bedrooms 3 Type of Water Supply: ❑ Community Public ❑ Well Distance from well L©d feet System Type: LG 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. 11111 ,ynem nas oeen ms[aneo in nrnum rnunir - wIm applicable north taroima beneral Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization. 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 ❑ NL-15~1 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 property. Type of system: ❑ Conventional Other Cam- ~1 aw Subsurface No. of exact length Drainage Field ditches of each ditch feet French Drain Reouired: 1 intoar Septic Tank: ~ o e o gallons Pump Tank: gallons width of depth of ditches -3 feet ditches T? inches Authorized State Agent n~~ a . 9-c-A5 Date aIal4ho G06p6r%' '.,oop ,s ` F 77 r I If 41 l s - C r ~ - i k ~ ,4~ ~ ~5. - mot.;~. _R _ x m