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OP RRHTE# `T Harnett County Department of Public Health PERMIT # a-~3so Operation Permit 22731 New Installation ~ Septic Tank Nitrification Line 0 Repair F Expansion PROPERTY LOCATION: ©oc,s 9--r.> Name: (owner) \-I `y N N Ca 35 sn.-\jCS ~ U N SUBDIVISION _Ts+sza•-;'c2~ ~Z C E LOT # ~ O System Installer: ~tioa~ g ~5 Qt- m5-,,A ii Registration # Basement with plumbing: ❑ Garage 'X Number of Bedrooms L) Type of Water Supply: ❑ Community Public ❑ Well Distance from well , feet System Type: Types V and VI Systems expire in 5 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 Disposal, and all conditions of the Improvement Permit and Construction Authorization 13~ ~ -r } ~ 1 150 10 E 1A1 t-1 A ~ IA PERMIT CONDITIONS: 1. Performance: System shall perform in accordance with Rule .1961. 11. Monitoring: As required by Rule .1961. 111. Maintenance: As required by Rule .1961. Other: Subsurface system operator required? Yes ❑ Nox If yes, see attached sheet for additional operation conditions, maintenance and reporting. IV. Operation: V. Other: 'Pu m4 - '0, )_WZ ~,N ` N z _ 'Tv ESE C0 EGA ❑ D-Box ❑ Pump ❑ Alarm ❑ H20Line ❑ PWR Line following are the spe cifications for the sewage disposal system on the above captioned property. Type of system: ❑ Conventional X Other \0 y rn?-To ~.c.~r 1 Al + Septic Tank: Vo00 gallons Pump Tank: 4 ©QCQ gallons Subsurface No. of exact length width of depth of Drainage Field ditches a of each ditch Sd0 feet ditches 3 feet ditches AZ1')'~C inches French Drain Required: Linear feet Authorized State Agen •a' r~ Date cj~ r y 1 .-t . .1 u e P Wa s~~' Go-:: 7b T "qY 3A 0 t ~ is 4 d , M7 . } y P zr- ' qy