P1100 No Creek Rd DAVIE COUNTY HEALTH DEPARTMENT
44 (Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR ?" DATE PERMIT
LOCATION 1100
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
NO. BEDROOMS NO. BATHROOMS House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. . 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House 900 Gal. 900 Sq. Ft.
AUTO. ;DISHWASHER YES ❑ NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES No ❑
SIZE OF TANK _ '.� gal.
NITRIFICATION FIELD y4r,),0 sq. ft.32 ow `tom
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Ll Public ❑ l�
IMPROVEMENTS PERMIT BY INSTALLED BY
CERTIFICATE OF'COMPLETION _
By Date
(8/16/73) *Construction must -c.otAy with all other app icable State and local regulati ns
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