A26 29.�
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PERSON COUNTY HEALTH DEPARTMENT
SEWAGE DISPOSAL
IMPROVEMENTS PERMIT NO.
Issue Date: 7_ i 7-
Owner:
Sepi�`ic Tank'C�tractor:
Building Contractor:
Water Supply: Privata_
+�r t All wells should be 100 ft. from sewer system.
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Lot Size: [j.� � �'1 rs
Sewage Disposal Fa i�ies: No. bedrooms /
Size of tank: Nitrification line:
1
Other disposal facili
Water supply and sewage disposal facilities location, installation and
protectiion must meet state and local regulations.
Septic tank shauld be pumped out every 3 to 5 years and shall be
maintained by owner in such a mannez as not to create a public health
hazard. Septic tank and nitrification line HUST BE INSPECTED AND
APPROVED BY A MEMBER OF THE PERSON CO. HEALTH DEPARTMENT STAFF BEFORE
ANY PORTION OF THE INSTALLATION IS COVERED AND PIJT TO USE. THIS
PERMIT VOID A£TER 3 YEARS.
Date Well Approved: '
By:
Date Sewage Disp sal p�ve :_
'/
By:
Certificate of Completion
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-, Date Approved: '�
(Over)
L '`,� 1r : �
%
Counter-
signed
(Owner o his represen ative)
BY. ,�,,
Sanitarian
;Location of well and sewage disposal facilities sketched on back.
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