441 Markland RdDAVIE COUNTY HEALTH DEPARTMENT
'` �--- --- (Septic -Tank) -Improvements Permit and Certificate of Completion "
or. (Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
C. {•x :cr<( t(�e.i =* t� %�j� PERMIT OR CONTRACTOR DATE
- N°
LOCATION {'1'1,� !� �: � s: rz+"5 '�" <�.� :k ? •^ f� 3_ r' �-"�' 1 i
SUBDIVISION NAME
LOT NO.
HOUSE ❑ MOBILE HOME ® BUSINESS
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ES
AUTO. DISHWASHER YES ❑ NO
AUTO. WASH. MACHINE YES CEJ NO ❑
SITE SUITABLE YES Q NO ❑
SIZE OF TANK (ED gal.
NITRIFICATION FIELD c+c sq. ft.
DEPTH OF STONE IN LINES: i� `�-• /'
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY_ ,? /'r'# �
` S.R. NO.
SECTION OR BLOCK NO.
112
House Trailer
800 Gal.
400 Sq. Ft.
Two Bedroom House
800 Gal.
600 Sq. Ft.
Three Bedroom House
900 Gal.
900 Sq. Ft.
Four Bedroom House
1000 Gal.
1200 Sq. Ft.
Tx
tA
INSTALLED BY
CERTIFICATE OF COMPLETION By N.`_ i1.:?y�Date _7
(8/16/73) *Construction must comply with all other applicable State and local regulations
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