P338 Bracken RdDAVIE COUNTY HEALTH •DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Dis1 f,posal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR �'i"`�I' t''� el! 1'1 .,j .i DATE r`"i,:�.'?;.�r, �'5"'`�+'PERMIT
LOCATION.A l (9 ..
SUBDIVISION NAME
S. R. NO.
LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME D BUSINE�S ❑
`R
NO. BEDROOMS �N(SBATHROOMS
GARBAGE DISPOSAL UNIT �-Eq ❑ NO U y
AUTO. DISHWASHER YES ❑— NO Q
AUTO. WASH..MACHINE YES ETA',, 'NO' ❑
SITE SUITABLE YES [ NO ❑j
SIZE OF TANK oOtO gal. Jr �o �`,'j(ZC114s
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual , Public
IMPROVEMENTS PERMIT BY
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
338
800 Gal. 400 1Sq. Ft.
800 Gal.,
�- Or L5P_§ q .F t
1000 Gal. 1200 Sq. Ft.
INSTALLED BYf r hV� ��p yrsN 5i •
CERTIFICATE OF COMPLETION By
(8/16/73) *Construction must comp!L with 'all other ap
LOT AREA (� C.r[►C/t.A.Q__
Date 7'T —I f 4L
ile State and local regulations