7835 Hwy 801S DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR
DATE �� .. w? — �j '. PERMIT
N •� 842
LOCATION l r :'S
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
T)A,,.f
HOUSE ❑ MOBILE HOME BUSINESS ❑
.1 House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS Two Bedroom House 800 Gal. 600 Sq Ft.
..
GARBAGE DISPOSAL UNIT YES El NO [9--" Three Bedroom House X900 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 j --- gal.
NITRIFICATION FIELD r sq. ft.
DEPTH OF STONE IN LINES: r&,N w ;Ork 1 �
WATER SUPPLY: Individual ®''Public ❑
IMPROVEMENTS PERMIT BY� INSTALLED BY
CERTIFICATE OF COMPLETION
By_
Y YQODate —a 3'7L
(8/16/,73) *Construction must c mply with all other applicable State and local regulations
LOT AREA
S
1 .
1 !