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�'�����a ���nt� �e�9th �e��r�r�e�� �
�@�.���� ������ �r�aproverne�$� P���i� ;
Date: t��`f y'� This Per�nit Void After 5 Years Permit #��"� -� 1�`
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Owner: ��;s�l,���,! i�/�. ,::a � t� SR# ��^
Location/Directions: r
Subdivision Name: r G�� %' " Lot #��'-�'�_
Lot Size: '�' �' � Type of Dwelling:
Water Supply: Private: Public: Community:
Bedrooms: � Garbage Disposal �.�f '' „
Basement Basement Fixtures : -% � _;�€r �' �
INF�RMt�'�'ION C�RTIF�D BY ::� C, •' . �-.. _
Environmentai I3ealth Specialist: � ., � o e or r T '�e
REPAIit: REEV � UATTO ; �,
Size of Septic Tank: �° gallops Size of Pump Tank:
�Titrificatian Line: ��� / � 's i
Depth of Stone: 12 inches �
Nia:c Depth of Trenches:
Altemadve System: Conv. Pump LPP Pump
' �2emarks: � t' l. ; % � ,�/ i1 1_ :�'"' z' � ,� �, :
���.�.� �� � ' .,'�Y ��� ���� ��� ����
. �,'`� >!�' - � �
Date Well Approved. Well should be 100 ft from any sewer system
BY ! Environmental Health Specialist
Date ��ewagej ��y�. fje Approv���_�� ^ •- �' �
BY.-` ',f���°'�-�tiY�% �-�-��� ��" Environmental ealth Specialist
.TE OF COMPLETTON
Conteactor.
Sewage System location, installacion, and protection must meet state and local
regulations. Septic tank should be pumped out every 3 to 5 yeazs and shall be maintained
by ownez in such manner as not to create a public health hazard. Septic tank and
ni�cation line must be inspected and approved by a member of the Person County
Health Department before any portion of the installation is covered and put into use. If
ihe site plans or intended use change this pemrit is subject to revocation.
(G.5.130 A-335F)
Location of sewage disposal sewage system sketched on back.
(OVEI�)
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�e�son County Health Departrnent �
�ew�ge SysterYa Ir�provemerats Perr�ai#
Date: "� �'� This Pe it Void After 5 Years Permit # E�� ''� (� �
Owner: �,+�.✓TiE..,�J—�,�z.:? /� � _ SR# „
Location/D'uections:
Subdivision Name: � � � Lot # �
Lot Size: ' Type of Dwelling:
Water Supply: Private: Public: Community:
Bedrooms: � Garbage Disposal �'
T +,
Basement Basement Fixtures : -�" � - %� �--
INFQRMATION CERTIF'IED BY ' ��
Environmental Health Specialist: � o e or r �ve
REPAIR: REEV UATIO : ��
7 —��/�, ��, ----
Size of Septic Tank: �/ �� gallops Size of Pump Tank:
idibrification Line: i-,�("1 � � � � �
Depth of Stone: 12 inches
Max Depth of Trenches:
Altemative System: Conv. Pump LPP Pump
Remarks: ., I' l ; l �/JJ i� �_�' z' ���
---�--- -------------
G,�' � :� ��� -
Date Well Approded: Well should be 100 f� &om any sewer system
BY Environmental Health Specialist
. Date � wa e��vstem Annmved: � � ! �= �- �-� �
BY,� ��� �'� Environmental H`ealth Spe�ialist I
�.._. CATE OF COMPLETION ,�
Contractor. :. ;� � jd� !' „ �
x
------ L------------------ �
�
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 hazard. Septic tank and �
ni?rification line must be inspected and approved by a member of the Person County
Health Department 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 revocarion. �
(G.S.130 A-335F) �
�
Location of sewage disposal sewage system sketched on back. '�
(OVEK)