A41 33z
Person County Health Department �
Sewage System Improvements Permit
Date: � This Permit Void ter�Years
Owner: j •� SR# 1 / �-D '
Localion/Direcaon .
Subdivision Name: Lot #
Lot Size: 3� � 3 R��' Type of Dwelling: .
Water Supply: Private: �— Pablic: Community:
Bedrooms: � Garbage Disposal �o
Basement t�/�1— Basement Fixtures ii/rb ,
Sani[arian:
REPAIR:
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Size of Septic Tank: fX�C7 3 p,�llons Size of Pump Tank:
Nitri�cation Line: ��v� � �4.�„�
Depth of Stone: 12 inches U�
Max Depth of Trenches:
Altemative S tem: Conv. Pump LPP Pu p
Remarks: � ,.,� � c
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Date Well Approved: �� ell should be 100 fG from any sewer system
BY anitarian
Date S w ge yst prov : -
BY anitarian
`r � ' CERTIFTCA'TE O�COMPLETION
Contractor. ���nr. �Av�ha _ _ . q � � - S'�0 (� o ►- 7 �o- �Zo b
�—
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Sewage System location, installation, . and protection must meet state and local '�
regulations. Septic tank should be pumped out every 3 to 5 years and shall be maintained �
by owner in such manner as not to create a public health hazazd. Septic tank and'd
nitrification line must be inspected and approved by a member of the Person County �
Health Depaztment before any portion of the installation is covered and put into use. If
the site plans or intended use change this permi� is subject to revocation
(G.S. 130 A-335F) • �-�- -
�
I.ocation of sewage disposal sewage system sketched on back. �
(OVER) �
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