P735 Gun Club 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 iJ DATE t_ i.,` PERMIT
LOCATION ! .^~. .� .1 ��� i' ;� ,1 (` r 735
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME Q BUSINESS ❑
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 Aa,c Nj, , gal. 3o �tj
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES: J
WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BY �1, ,-~ 4•
House Trailer
800
Gal.
400
Sq.
Ft.
Two Bedroom House
800
Gal.
600
Sq.
Ft.
Three Bedroom House
900
Gal.
900
Sq.
Ft.
Four Bedroom House
1000
Gal.
1200
Sq.
Ft.
__.INSTALLED BY
CERTIFICATE OF COMPLETION By Date 10 - Z
(8/16/73) *Construction must c ply with all other applicable State and local regulations
LOT AREA
q