P693 Hwy 801S DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements 1ermit�and Certificate of Completion
- • (Ground Absorption, Sewage Disposal System - G.S. Chap
ter ,130-Article 13C)
OWNER, OR CONTRACTOR . . , ^t s-ADATE ,'. - PERMIT
LOCATION '', Ec �; �� �`. Y ,, y �� v" lr 693
S.R. N0,
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME E3 BUSINESS ❑
'House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS N0. BATHROOMS Two Bedroom House 800 Gal. 600 S Ft.
GARBAGE DISPOSAL UNIT- YES .❑ NO ❑ Three Bedroom House .900` Ga -. -900 Sq Ft's
AUTO. DISHWASHER YES,j:3 NO ❑ Four Bedroom HouseFt.
AUTO. WASH. MACHINE YES ❑ NO Q
SITE SUITABLE YES ❑ NO ❑
SIZEgal.
f.S,e'3 D'
. .- OF TANK
NITRIFICATION FIELD sq. ft.
DEPTH OF. STONE,,IN LINES: e{ (^ ��`
WATER SUPPLY: .'Individual E Public 11
IMPROVEMENTS_PERMIT BY INSTALLED BY , ` s
CERTIFICATE OF ,COMPLETION.
Dat
73) .` *Construction .mustco y With all other applicabl'e. State and local regulations
LOT AREA 4r er;
fir
s'• i�