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OP RHTE# OF /I / 7 `"/e Harnett County Department of Public Health 2 0 6 8 3 PERMIT # 0 eration Permit ©/New Installation E Septic Tank ❑ Re air Nitrification Line ❑ Expansion PROPERTY LO(ATION: 52 /II,~ ,c~(o G_o kt~ f~ ct . Name: (owner) SUBDIVISION -,6744~~Ic) LOT System Installer: G"I&V Ca, Registration # Basement with plumbing: ❑ Garage ❑ umber of Bedrooms Type of Water Supply: ❑ Community I Public ❑ Well Distance from well feet System Type: 77- b 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. INS 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. -3 h S h 1 a ~ 6 N ty PFRNIT rnIJnITlAM(- I. Performance: 11. Monitoring: III. Maintenance: System shall perform in accordance with Rule .1961. As required by Rule .1961. As required by Rule .1961. Other. IV. Operation: Subsurface system operator required? Yes ❑ No ❑ If yes, see attached sheet for additional operation conditions, maintenance and reporting. V. Other. ;/,,e /r4HikS { v. CX 7 9 ~9&M kt SX~Gra 0'- yldtir Ok, Following are the specifications for the sews dispos6system oq the ve captioned prop rty. Type of system: ❑ Conventional L~1 Other FJ~A-.p +a 0, C co• b"~,- Septic Tank: j0"Qi Q gallons Pump Tank: d~ gallons Subsurface No. of D i F exact length width of depth of ra nage ield ditches of each ditch feet ditches feet ditches inches French Drain Required: Linear feet Authorized State Agents Date 7 /f 7/'i Qi3 x Apt k . now to 41, § r_. r t ``s'4. l eg a j k { Al +09 A. I a e' r ii. O -j-/7/ /'1 1'- m e~ k ~ ' b ~ ~ a F-J-/qr-7yfl yw Y' ~ E } r f 1 ~ ~ y ~