A23 154/
"""Person County Health Department
Sewage System Improvements Per
mit
`., , � �
Subdivision Name: '" Lot #=�
Lot Size: of Dwelling:
Water Supply: Private: Public: Communiry:
Bedrooms: 3 � Garbage Disposal
Basement Basement Fix es �
INFORMATION CER'I'IFIED BY ' -
Environmental Health Specialist: �eres i
REPAIR: REEV TION:
---------�/��—"----------------
Size of Septic Tank: –.��— gallons Size of Pump Tank:
Nitrification Line: "�(� ��C 3 �
Depth of Stone: 12 inches
Max Depth of Trenches:
Altemative System: Conv. Pump LPP Pump
Remarks:
Date Well Approved:
BY
Date g Sy
BY
Contractor.
_ Well should be 100 f� from any sewer system
_ Environmental Heal[h Specialist
/i4 � _Gi�
� Environmental Health Specialist
�ATE OF COMPLETION '
Sewage System location, installation, and protection must meet state and local
regulations. Septic tank should be pumped out every 3 to 5 yeazs and shall be maintained
by owner in such manner as not to create a public health hazard. Septic tank and
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 permit is subject to revocation.
(G.S.130 A-335F)
I.ocation of sewage disposal sewage system sketched on back.
(OVER)