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OP1b-5-401sr1g2 L HTE#17-5-L 4773 PERMIT # 2.C1151 Name: (owner) t'i ens System Installer. Basement with plumbing: ❑ Type of Water Supply: ❑ Col System Type: (In accordance with Table V a) Harnett County Department of Public Health 24620 Operation Permit New Installation V Septic Tank -35( Nitrification Line ❑ Repair ❑ Expansion s t� PROPERTY LO(ATION: Gn, /a_Eti4'ANct>,e+ SUBDIVISION LOT # w V es a Registration # Garage Number of Bedrooms 3 unity >( Public ❑ Well Distance from well feet MT! _ Types V and VI Systems expire in S years. Owner must contact Health Department 6 months prior to expiration for permit renewal. This system has been installed in compliance with applicable Nonh Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Consmidion Authomation. M� G— No us( 2� 1 U/.J D R i I I C- T amt 2 t 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 ❑ N�ox If yes, see attached sheet for additional operation cc maintenance and reporting. ❑ D -Boz ❑ Pump ❑ Alarm ❑ 1-12O1-ine ❑ PWR Line Following are the specifications for the sewage disposal system on the above captioned property. Type of system: ❑ Conventional Other EZ VL a'y Septic Tank: l©Ci 0 gallons Pump Tank: gallons Subsurface Drainage Field No. of ditches exact length of each ditch � feet width of depth of ditches 3 feet ditches ali —30 inches French Drain Required: ear feet Authorized State Agent Date 13 611 �G-5- LAO 1516Z2