P704 Gilbert RdDAVIE COUNTY IIEALTV DEPARTMENT
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(Septic Tank) Improvements Permit and Certificate of Completion
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(Ground Absorption/Sewage Dis�osal System - G.S. Chapter -130 -Article
13C)
OWNER OR CONTRACTOR /(/ _; �=� ; ,,� ,, ; ... DATE
PERMIT
LOCATION_ /: ff i -of !"l
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N 704
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NO.
SUBDIVISION NAME LOT NO. SECTION OR
BLOCK NO.
HOUSE ), MOBILE HOME BUSINESS ❑
House Trailer 800
Gal. 400 Sq. Ft.
NO. BED ROOMS NO. BATHROOMS
Two Bedroom House 800
Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
Three Bedroom.House 900
Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES ❑ NO ❑
Four Bedroom House IaO a `LZOO�Sq: Ft.
AUTO, WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public ❑
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IMPROVEMENTS PERMIT BY 4rt_',',1 r " " r.->�
INSTALLED BY,,/
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CERTIFICATE OF COMPLETION e
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Date
(8/16/73) *Construction must comply with all other applicable State and
local regulations
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