P28 Eatons Church RdDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorp on Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR (`/ DATE PERMIT
'O
LOCATION �; 1l 1\ . 28
S. R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE a MOBILE HOME ® BUSINESS
I
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK O ti gal.
NITRIFICATION FIELD 4 0 6d 0 sq. ft.
DEPTH OF STONE IN LINES: ;-.r�
WATER SUPPLY: Individual �' Public ❑
IMPROVEMENTS PERMIT BY i
CERTIFICATE OF COMPLETION
BY—
(8/16/73) *Construction must
LOT AREA
House Trailer 800 -Ge+-- 400&-Sq".&t.
Two Bedroom House 800 Gal.410-0i-qFt.
Sq. Ft.
Three Bedroom House 900 Gal 00 Ft
Four Bedroom House 1000 Gal.
INSTALLED BY '
fid/rLc�.t;•rrr„�
Date .•- J ..
--
with all other -applicable State and local regulations
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DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130- rticle 13C)
OWNER OR CONTRACTOR ~�/ .+F'n'.^�..'�st.. E•' t DATE•-`! PERMIT
N° 28
LOCATION
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME Q BUSINESS
r
NO. BEDROOMS j NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK 0 gal.
NITRIFICATION FIELD 1 4 o { sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual .-!p Public ❑
IMPROVEMENTS PERMIT BY —&-4s., t..). m•. =
House Trailer 60 40e-tTP-k%e.
Two Bedroom House aQQ,,Gal. b.D �,.Z9. t.
Three Bedroom House 900 Gal ,90L4g..Ft
Four Bedroom House 1000 Gal. 1200 Sq Ft.
INSTALLED BY 'j --
CERTIFICATE OF COMPLETION i +.
gy ... '�. Date
(8/16/73) *Construction must com with all other. -applicable State and local regulations
LOT AREA
ti
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