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
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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