537 Log Cabin RdDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewagp Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR � f: � p r.! ' P* nr DATE PERMIT
N° 16
LOCATIONrf r'/r C •. l d
S. R. NO.
SUBDIVISIOi,NAME,.LOT NO. SECTION OR BLOCK NO.
HOUSE A MOBILE HOME ❑ BUSINESS ❑
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑NO [3AUTO. WASH. MACHINE YES NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK Qt7 gal.
NITRIFICATION FIELD
---
sq. ft.
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DEPTH OF STONE IN LINES /
WATER SUPPLY: Individual
Public El
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IMPROVEMENTS PERMIT BY 6,-Udf le
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. 600 Sq. Ft.
Three Bedroom House [��0JGal. 900 Sq. Ft.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
INSTALLED BY ,
CERTIFICATE OF COMPLETION_ ±�—1-(�.i
By •� Date
(8/16/73) *Construction must comply with all other applicable State and local regulations
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