367 Daniel RdDAVIE COUNTYTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)=
OWNE1t OR CONTRACTOR +� /a / P c !.e « 01 DATE t1r" -/Y PERMIT
7 '
LOCATION ) :�;h` j `• '! %µ' 1 ft,C1i"r fI11"�/:. N? 404
S.R. NO. //
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME BUSINESS ❑
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES Er NO ❑
AUTO. DISHWASHER YES Q" NO ❑
AUTO. WASH. MACHINE YES ( NO ❑
SITE SUITABLE YES C''1NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD q" sq. ft.
DEPTH OF STONE IN LINES: / frv'r
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY C1�r4 1'1"'tCvw.& 0
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
800 Gal. 400 Sq. Ft.
80..p La.1... �- Sq;_..F.t.
��.O.1 1-;) �RIl4 Sq�_ Ftp
1000 Gal. .1200 Sq. Ft.
INSTALLED BY 'PA vi C- eo-
CERTIFICATE OF COMPLETION Byt r�Z ti�D Date 7�
(8/16/73) *Construction must camply with all other applicable State and local regulations
LOT AREA
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