1516 Deadmon RdDAVIE 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 _ � ! :� } c C.', ,G� `; i DATE -0 PERMIT
LOCATION �y, t .... r; — b. , ;;, t ; . N° 415
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S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME 0 BUSINESS ❑
NO. BEDROOMS N0. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK E14`ia gal.
NITRIFICATION FIELD cry sq. ft.
DEPTH OF STONE IN LINES: / Faa
WATER SUPPLY: Individual Public [❑
IMPROVEMENTS PERMIT BY .. 1 ' . r. , .
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Cq1. 600 Sq. Ft.
Three Bedroom House ! 9_Q_Qo,;Q9 90� 0 Sq. Ftp-,;>
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
INSTALLED BY
CERTIFICATE OF COMPLETION By Date
(8/16/73) *Construction must amply with all other applicable State and local regulations
LOT AREA
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