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OPH T E # I s -41215 Harnett County Department of Public Health 24712 PERMIT # 2 -`a4$ -'Of Oueration Permit [a'-N—ew Installation Otic Tank mon Line ❑ Repair ❑ Expansion PROPERTY LOCATION: 6o craw. A Gr,,KIeC o . (36 10 z 54- 0 Name: (owner) SUBDIVISION LOT # System Installer: H �S,v., wtUic,,rns Registration # IItCS_, Basement with plumbingbing 11 Garage ❑ Number of Bedrooms 3 Type of Water Supply: ❑ Community E?- uf' blit ❑ Well Distance from well 1�q feet System Type: 2-65c c Sts ;Z — Types V and Yl Systems expire in 5 year. (In accordance with Table V a) Ownecontact Health Department 6 months prior to expiration for permit renewal. This system has been instilled in compliance with applicable North Carolina General Statutes, Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and Construction Authorization V/ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PAIR Line Following are the specifications for the sewage disposal system on the above captioned property. Type of system: ❑ Conventional �LV w Septic Tank: gallons Pump Tank gallons Subsurface �5 L3j exact length width of depth of Drainage field I 3 of each ditch ;-5 feet ditches �_ feet I IN French Drain Required: Linear feet 91 � I I �RJNUS X67 P4w� t-'>• 51 al ST I_IS Pnv 405 EJ> wAT�Z 3 a a ct C 2Y $TR t.. raj rL 46✓ aLNV b '� C-SCL- ISrjw rcKrl l IVnuiIIVna: 1. Performance: System shall perform in accordance with Rule .1961. II. Monitoring: As required by Rule .1961. III. Maintenance: As required by Rule .1961. Other. Subsurface system operator required? Yes ❑ No If yes, see attached sheet for additional operation conditions, maintenance and reporting. IV. Operation: V. Other. ❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PAIR Line Following are the specifications for the sewage disposal system on the above captioned property. Type of system: ❑ Conventional er T ;-- CC - Septic Tank: gallons Pump Tank gallons Subsurface No. of exact length width of depth of Drainage field ditches 3 of each ditch ;-5 feet ditches �_ feet ditches inches French Drain Required: Linear feet Authorized State Agent Date 1 11 I 2 c /'ao R --:L— ,,f G -i� pyo � t `„RS' � `.. .4'` w� 'h _ \ . 4 � r__ � - .__ .. ya N� ,_1 ,,f G -i� pyo � t `„RS' � `.. .4'` w� 'h _ \ . 4 � r__ � - .__ ..