A23 381��3J3� -
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Person County Health Department
Sewage System Improvements Permit �
Date:� is Permit Voi ter 5 Years
Owner: - � � SR# i �,�
, � ,
T .rr�tinn/'f)ire.ctinns: �" "'�
Subdivision ame: � �
Lot Sizc: � Type of Dwellin •_
Water Supp y: Private: ��-� � Public:
Bedrooms: �—� Garba�e Disposal
Basement T Basement ix es
INFORMATION CER'I��D BY, ,--
SaIlit�iall: � `' ':� !�`�r!, ouner or
�;r,, "
REPAIR: ��y7_ 9L'�+REE. ATION:
Lot #
Community:
-------P+r--=--------------
Size of Septic Tank: , �;` �� '� gallons Size of Pump Tank: ��' �'
Nitrification Line:
;' `" r ; -� .� � ..
Depth of Stone: 12 inches
Max Depth of Trenches:
Altemative System: Conv. Pump , LPP Pump
Remarks:
Date Well
BY
Date Se �
BY
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� Well should be 100 f� from any sewer `system
v��
TE OF COMPLETION
�
�
Contractor. `�^-
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Sewage System location, installarion, and protection must meet state and local �
regulations. Septic tank should be pumped out every 3 to 5 yeus and shall be maintained �
by owner in such manner as not to create a public health hazazd. Septic tank and`d
nitrif`icadon line must be inspected and approved by a member of the Person Counry �
Health Department before any portion of the installation is covered and put into use. If
the site plans or intended use change this pennit is subject to revocation.
(G.S. 130 A-335F) ....._
Location of sewage disposal sewage system 'sketched on back.
(OVER)