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OPHTE0 6— 5-4 o3a `T Harnett County Department of Public Health 2 4 4 5 9 PERMIT # 010113© Operation Permit New Installation Septic Tank Nitrification Line 11Repair 11Expansion c yy PROPERTY LOCATION: MS�ucaw Qw Name: (owner) a K%114 Q> SUBDIVISION LOT # System Installer: C rS—)) s, S-72, cY qaG Registration # Basement with plumbing: 11 Garage Number of Bedrooms Type of Water Supply: ❑ Community Public ❑ Well Distance from well 100 feet System Type: 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 ha been installed in compliance with applicable North Carolina General statutes, Rules for Sewage Treatment and Dispmal, and all conditions of the Improvement Permit and Construction Authomation. i1D'uJ W"vb r 4R�4 , a� Yo rV 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 ❑ Nq;K If yes, see attached sheet for additional operation conditions, maintenance and reporting. ❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line Following are the specifications for the sewage disposal systemon the above captioned property. Type of system: El Conventional � E.'Z iOther iow Septic Tank 10>00v gallons Pump Tank gallons Subsurface Na. o exact length width of depth of Drainage Fieldditches of each ditch S feet ditches 3 feet ditches (� inches French Drain Required:, r feet Authorized State Agent PAW Date 3 n 16 - 5- L, 0-5-a � M ,7-7