P931 Will Boone Rd DAVIE COUNTY HEALTH DEPARTMENT
_ (Septic Tank) Improvements Permit and Certificate of Completion
ound Absorption Sewage Disposal System - G.S. Chapter 130-Article 13C
OWNER OR CONTRACTOR DATE '.. --'�„ PERMIT
ATO9 31
LOCATION h
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SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
_ House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS
-r.-_— 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 0,-"NO ❑
SITE SUITABLE t YES [a, NO [3SIZE OF TANK c�,. _ , . e,r gal.
NITRIFICATION FIELD , L,-, .,���;�,, sq. ft.
DEPTH OF STONE IN LINES: *� Jai 0 , i'
WATER SUPPLY: Individual) [U--Public ❑ i
IMPROVEMENTS PERMIT BY '/ o:., ?�� ,.. _; INSTALLED BY
CERTIFICATE OF COMPLETION
BYDate � � " ?
(8/16/73) *Construction must co y with all other applicable State and local regulations
LOT. AREA ✓t e'
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