P878 Broadway RdDAVIE COUNTY HEALTH DEPARTMENT BrooAviN -Po(.
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR DATE 71' PERMIT
.LOCATION �� C'� c� �s C" fi`.P' • �: t ;` j'; <� + 1\ 878
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE [Do,` MOBILE HOME BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
N0. BEDROOMS N0. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES Cl NO ❑ Three Bedroom House 900 Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES: � v\
WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BY`Tf
INSTALLED BY a , f ""� • �.
CERTIFICATE OF COMPLETION B .! � � -as —74
Y Date
(8/16/73) *Construction must �omply with all other applicable State and local regulations
LOT AREA
7