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HTE# 15-S-
Harnett
County Department of Public Health
23868
PERMIT # al%( -K
Operation Permit
New Installation —X Septic Tank ,X Nitrification Line
❑ Repair ❑ Expansion
PROPERTY LOCATION: '0%ML6N
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Name: (owner) `N�wV6A,
CEL -4G &t rNF.NC
SUBDIVISION N,,omo%5 MPsNOCL
LOT #T10
System Installer. , e�—, auc.
Registration #
Basement with plumbing: ❑ Garage
Type of Water Supply: ❑ Community
Number of Bedrooms
Public ❑ Well Distance from well L 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 States, Rules for Sewage Treatment and Disposal. and all conditions of the Improvement Permit and Construction Author ion
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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 ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑ D -Box ❑ Pump ❑ Alarm ❑ H2OLine ❑ PWR Line
Following are the specifications for the sewage disposal,syis�tem on the above captioned property.
Type of system: El Conventional Other LZ Fa—o-v Septic Tank: S 00 gallons Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches 1 of each ditch ci.y feet ditches 3 feet ditches 1$ inches
French Drain Reouired`Laeear feet
Authorized State A¢ent J� ��\*1� Date