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P311 Beauchamp RdDAVIE COUNTY HEALTH DEPARTMENT . (Septic..Tank) Improvements Permit and Certificate of Completion (Ground Absorption Sewage Disposal System - G.S. Chap er 130-Artic1e1JCIV) OWNER OR CONTRACTOR FOX � 42 y_ DATE PERMIT? LOCATION 4 -'� N . 311 :1.stt Cf�u,7r r? il� r �J t! /�M; `°, rr, s rw K+�`. CERTIFICATE OF COMPLETION By --A (8/16/73) *Construction must coi LOT ,AREA ,i ,tf .;r iii.. Date — th all other applicable State and loca regulations S. R. NO. SUBDIVISION.'NAME LOT NO. SECTION OR BLOCK NO. HOUSE ❑ MOBILE HOME BUSINESS ❑ --� BATHROOMS House Trailer 800 Gal. 400 Sq. Ft. NO. BEDROOMS *,.5 NO. 02Two Bedroom House 600,S Ft.. GARBAGE DISPOSAL UNIT YES ❑ NO Q`` Three Bedroom House 900Gal. � :,Ft:: AUTO. DISHWASHER YES ❑ NO [}"' Four Bedroom House 1000 Ga 1200 Sq. Ft. AUTO. WASH. MACHINE YES ( NO ❑ S SITE SUITABLE YES ❑ NO ❑ .SIZE OF TANK gal. ' NITRIFICATION FIELD sq. ft. DEPTH OF STONE IN LINES: WATER SUPPLY: Individual Public ❑ PERMIT BY �-� J �'` "� IMPROVEMENTS i -"E.. INSTALLED BY CERTIFICATE OF COMPLETION By --A (8/16/73) *Construction must coi LOT ,AREA ,i ,tf .;r iii.. Date — th all other applicable State and loca regulations