440 Bear Creek Church Rd DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption SewaZe Disposal System G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR
DATE i`7�" PERMIT
LOCATION 1298
S.R. RO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME/q BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES NO 0 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 0
SITE SUITABLE YES NO M
SIZE OF TANK 4 gals.
NITRIFICATION FIELD i; sq. ft. V Ifo
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY INSTALLED BY
CERTIFICATE OF COMPLETION By Date
(8/16/73) *Construction must conjKy with all other applicable State and local regulations
LOT AREA
A\
C)