P306 Fork Bixby 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 CONTRACTOR f !, , / .t „ :i .- .` "> c,� DATE
PERMIT
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LOCATION t �' .=r� /. !: �. r ;. �' r/t / ,+, r ,'
S.R.
NO.
SUBDIVISION NAME LOT NO. SECTION OR
BLOCK NO.
HOUSE MOBILE HOME BUSINESS ❑
House Trailer 800
Gal. 400
Sq. Ft.
NO. BE ROOMS _ NO. BATHROOMS
Two Bedroom House 800
Gal_ 600
Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO [� ` _
Three Bedroom House L9„ 001.) %&:ZFt
AUTO. DISHWASHER YES ❑ NO
Four Bedroom House 1000
Gal. 1200
Sq. Ft.
AUTO. WASH. MACHINE YES NO ❑
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c� =��`;�,. `�
SITE SUITABLE YES ®'� NO ❑
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SIZE OF TANK gal. G
f - .•
41
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NITRIFICATION FIELD
NITRIFICATION
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DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual .....Public ❑
IMPROVEMENTS PERMIT BY r._ :�;"»:�:z-+..�-•
'INSTALLED BY
CERTIFICATE OF COMPLETION By Date
(8/16/73) *Construction must co y with all other applicable State and local regulations
LOT AREA