P139 Bethel Church Rd!, DAVIE COUNT,Y.:HE�DEPARTMENT
(Septic Tank) Improvements'Permit`and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER DR CONTRACTOR DATE PERMIT
N? 139
LOCATION s"'•� = --i' l :�,!'1�t1P �"�J
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE 1 MOBILE HOME ❑ BUSINESS
NO. BEDROOMS %:f NO. BATHROOMS '•
GARBAGE DISPOSAL UNIT YES NO ❑
AUTO. DISHWASHER YES NO ❑
AUTO. WASH. MACHINE YES ❑ ',/ NO ❑
SITE SUITABLE YES C�i' NO ❑
SIZE OF TANK /r,00 gal.
NITRIFICATION FIELD Gd9 sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. 600 Sq. Ft.
Three Bedroom House 91y9-8 a.. .900 Sq. Ft.
Four Bedroom House 000 Ga 1200 Sq. Ft.
INSTALLED BY
CERTIFICATE OF COMPLETION By �,�� .��G f�� p Date
(8/16/73) *Construction must Cq ply with all other applicable State and local regulations
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