P335 Bear Creek Church Rd4 . -
DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absozption Sewage, Disposal System - G.S. Chapter ,130 -Article 13C)
OWNER OR CONTRACTOR r �'`� r' .jg� DATE ,,.,'= PERMIT
LOCATION d4'r reo X,���.� ,'� c �;, N° 335
SUBDIVISION NAME LOT NO.
HOUSE ❑ MOBILE HOME ❑ BUSINESS
NO. BEDROOMS NO. BATHROOMS ..
GARBAGE DISPOSAL UNIT YES ❑ NO
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH.,MACHINE YES NO ❑
SITE SUITABLE YES X1 NO ❑
SIZE OF TANK toogal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY Individual Public ❑
IMPROVEMENTS PERMIT BY t o L.r..,,
S. R. NO. l: Q0
SECTION OR BLOCK NO.
House Trailer
800 Gal.
400 Sq. Ft.
Two Bedroom House
800 Gal.
600 Sq. Ft'.
Three Bedroom House
900 Gal.
900 Sq. Ft:
Four Bedroom House
10050, Gal.
1200 Sq. Ft.
INSTALLED BY
CERTIFICATE OF COMPLETION
BY —' ?�n. Date g
(8/16/73) *Construction must pomp y with all other applicable State and local regulations
LOT AREA ON
4 ,,/ tom.