303 Gordon DrDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvemerif's`Peimif'and"Certificate of Completion
. (Ground Absorption Sewage Disposal
'►;
System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR ..., {, i
DATE
PERMIT
^�it�or
NO
�47
LOCATION _"1r- {•t� Vi L . �" ;` •�'.r. �..
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_
S.R.
NO. lt ill
SUBDIVISION NAME LOT NO. SECTION OR
BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS
❑
OR
�
House Trailer 8LOG al. 400
.,
S,g, t.
NO. BEDROOMS NO. BATHROOMS
Two Bedroom House
600
Sq.MFt
GARBAGE DISPOSAL UNIT YES ❑ NO R'
Three Bedroom House 900
Gal. 0a"3q""'''t
AUTO. DISHWASHER YES ❑ ' NO ❑
Four Bedroom House 1000
Gal.1200
Sq. Ft.
AUTO. WASH. MACHINE YES Er NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK �,, ?JY -7 gal.
NITRIFICATION FIELD ' :.., ,�� sq. ft.
DEPTH OF STONE IN LINES: •-a`'`j'�
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY
INSTALLED BY (p CJ ;'�
ea
C .
CERTIFICATE OF COMPLETION By Date
(8/16/73) *Construction must comfy with all other applicable State and local regulations
LOT AREA
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