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OP RHTE# 14 -5"403s,—:Z Harnett County Department of Public Health 24945 PERMIT # a'1233 Opera—tion Permi New Installation � Septic Tank Nitrification Line ❑ Repair ❑ Expansion PROPERTY LOCATION: 1(.O?� Ckd s,tb Name: (owner)'Ioc.M.,a t . P blzt <, t T,r-, SUBDIVISION LOT # System Installer: 2a 1e Registration # Basement with plumbing. ❑ arage ❑ Num f Bedrooms �3 Type of Water Supply: ❑ Community ublk ❑ Well Distance from well Nuc feet System Type: 9 S Se 11 —Types V and VI Systems expire in S years. (In accordance with Table V a) Owner must ontact Health Department 6 months prior to expiration for permit renewal. oris sysum nas Deen installed in compliance with applicable North Carolina General Statutes, Rules for Sewage Tmamnent and Disposal, and all conditions of the Improvement Permit and Consmuttion Awhorintion. ©n L;ne jSerrtii /I,Y nPra ^- anFR O; "Sub d v n t�1 �a'.Jrr1y t, (1 a�rh6 � 1G�YL 0. Vt-o..i f �) j W' lad I / More �.lnutl `i 4�. 4Q a�>toa l �? o V) 0 � Ava�ctr�a — Cs rL ki69) PERMIT CONDITIONS I. II. III. IV. Performance: System shall perform in accordance with Rule .1961. Monitoring: As required by Rule .1961. 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. Operation: V. Other. ❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line Following are the specifications for the sewage ch pe��I system on the above captioned fro Type of system: ❑ Conventional C346ther C C`n��nn1 � Septic Tank rGc—leJ gallons Pump Tank: gallons Subsurface No. of exact length�width of depth of � Drainage Field ditches 3 of each ditch Wf\` feet ditches_ feet ditches 10_aa inches French Drain Required: linear feet Authorized State Agent l' �`/tel/ Date4 1 (9010 o d5 i F' 0