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OP RHTE# ©$-S = ZOS i640 Harnett County Department of Public Health 2 0 4 6 3 PERMIT # 2 N$5 O eration Perm ~ New Installation 12 Septic Tank ❑ Repair ONitrification Line El Expansion PROPERTY LOCATION: S, _ ~uD3 LE,c1Zi16 Name: (owner) He-,,s :'oSUBDIVISION LOT # System Installer Registration # Basement with plumbing: ❑ Garage li~ Number of Be ooms Type of Water Supply: ❑ Community ❑ Public Well Dist, an,fro well feet System Type: Aa C~ Vm---)~ L,,~ L K~ 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. WG~! ~I o r~rs t i4-r Ti•~ E the S7sE-z,. Sys ~ - _ 04 \ 4t h 11 zoy oCDMIT CALMITIA10 - 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 Following are the specifications for the sew disposal system on the above captioned property . Type of system: ❑ Conventional [ir Other n4q - 47-) Septic Tank: M0 gallons Pump Tank:` O gallons Subsurface No. of exact length width of depth of Drainage Field ditches of each ditch 3120 feet ditches 3 feet ditches inches French Drain Required: linear feet Authorized State Age ~ -7 05 Ze"'I Date dEk - yL y"~1». 'r4; t ?ice` q t Air Z o fl f r, t+• raga a y t - N T 'Abe 40 y i K~ 1 x~ a a~ k ~ t~' sr ~ h ~a ter" t • All 0,10 Q F ^ r_ ~ ~ ~ ~ i ,i f• r .may r ~,•~w r r x n r *01 ra ~ e 0 r~ tVA Oil' I t :tFc~ a, 1 `S¢ R! L F ^ t r + ~ t R h e ~ f s o l ~ f „ } k v~ e , v }z r ~ S~1 1 1 y N 1 'J `