P932 Deadmon RdDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank�m'provements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal
System
- G.S. Chapter 130 -Article 136),
OWNER OR CONTRACTOR �, : t ! .r •r r
Ft.
DATE .,; t , - D,.,
PERMIT
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LOCATION
i
Ft.
932
f"
900
Sq.
Ft.
SUBDIVISION NAME
LOT NO.
SECTION OR
BLOCK NO.
HOUSE ❑ MOBILE HOME 2` BUSINESS
�I
NO. BEDROOMS - NO. BATHROOMS : �•;
GARBAGE DISPOSAL UNIT YES ❑ NO D�
AUTO. DISHWASHER YES ❑
AUTO. WASH. MACHINE YES ❑
SITE SUITABLE YES ❑ --NO ❑
SIZE OF TANK ~ = /Qo gal.
NITRIFICATION FIELD f" +`,+'?t,� j:} sq. ft.
DEPTH OF STONE IN LINES:`; �' • r'
-WATER SUPPLY: IndividualPublic ❑
IMPROVEMENTS PERMIT BY (... t r ,:.»' , « �•
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
800
Gal.
400
Sq.
Ft.
800
Gal.
600
Sq.
Ft.
900
Gal.
900
Sq.
Ft.
1000
Gal.
1200
Sq.
Ft.
INSTALLED BY �; „�Q F,,4 -
CERTIFICATE
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CERTIFICATE OF COMPLETION By �� Nr\6AJIC� Date 7 —2, -76
(8/16/73) *Construction must.ccf4ply with all other applicable Stat and local regulations
LOT AREA
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