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OPHTE#/0 -s'-2y.? ~ Harnett County Department of Public Health 21 0 5 4 PERMIT # Zv7 Operation Permit 7/New Installation Septic Tank ❑ Repair Z /Nitrification Line ❑ Expansion PROPERTY LOCATION:,_--reVy Zj±!:- Name: (owner) ae- SUBDIVISION ~/i,,ts„a LOT # .j'L System Installer: c6cw- Registration # Basement with plumbing: ❑ Garage /Number of Bedrooms 3 Type of Water Supply: ❑ Communi 5 Public ❑ Well Distance from well feet z2 " System Type: Ls°~6G~hx kc ) fyM-207-G Ez Types V and VI Systems expire in S years. (In accordance with Table V a) / Owner must contact Health Department 6 months prior to expiration for permit renewal. This system has been installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and /7A) car (~i /gyp fu s' t Opt? 0 i r PA- PERMIT CONDITIONS: 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 conditions, maintenance and reporting. Following are the specifications for the sewage- disposal system on the above captioned property . Type of system: ❑ Conventional Other ~~5 uZR6 ~Zic Tank: f~a gallons Pump Tank gallons Subsurface No. of exact length width of depth of Drainage Field ditches of each ditch S feet ditches - feet ditches ?y Xf inches French Drain Required: Linear feet and all conditions of the Improvement Permit and Construction Authorization. Authorized State A nt , _ 4- / v 6•~-1~3 Date I-) - / & / 0 : 1'7 It "G'~'.~ ~ f , } -0 ' . { .tea • ti~ i~ ~ . oto*) P . r- 10 7 ' 74, t~° ~ ~ a N • it 1► ' r s ,d N qz T , } k e4pO F, F ~t ~ ~ ~s,,~ ~ 1~: rte. f '~r . ~,u _ f " ./p~ f st, • ' ti"' sit ~ .t r } N.,4 of" AS~ it f'~• S ~r Fr A ~ 4~~bRee ~ ~ ~ ~ . 1~1.. N y e -11*Y,.. tea; 1 h N • ' ` ♦ ~T a ~ x ''t •n ' "'try Y• r ~ ~A ~ ' i rt -'Y tt~ - ~ ~ c t ~ A! 3 ;1 Sle t 4 i ik^~. » s ~ ~ w F 1 7. i,4 ? t ' a r F« ~ 4 ~ r j t }CAS' ~ r WA? J 5 I r ~,.ftic t Y r~ ~ t.. ~ tic C ' lop, } a- . 04 t y ! f s p Y t x A t t A ^nq k 4 t r. t i b ll • 7y y t r .,w l J ~i