P973 Farmington RdDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements' Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTORf DATE - PERMIT
LOCATION �� F, i �, , T j. N� 973
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE Ej MOBILE HOME ❑ BUSINESS ❑
NO. BEDROOMS NO. BATHROOMS i
GARBAGE DISPOSAL UNIT YES ❑ NO D--
AUTO.,DISHWASHER YES []' NO ❑
AUTO.:WASH. MACHINE YES 0 -,---NO ❑
SITE SUBTABLE 2 YES M NO ❑
SIZE OF TANK gal. V4 � � % -0
NITRIFICATION FIELD xj'n sq. ft.
DEPTH OF STONE IN LINES:
. WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BY _ 4
House Trailer
800 Gal.
400 Sq.
Ft.
Two Bedroom House
800 Gal_.
600
Ft.
Three Bedroom House
row -Gal ,
„Sq,.,,
-,}-900 Sq.
Ft.`.
Four Bedroom House
1000 Gal(.
700 Sq.
Ft."
JV
'
Q, .♦, 3
-INSTALLED BY
CERTIFICATE OF COMPLETION
By
(8/16/73) *Construction must LiapL5f with all other applic
LOT AREA
.4,,20
—
ilf
r
Date —�
ble State and loca regulations ql�
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