P76 Hillcrest DrDAVIE, COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of . Completion
(Ground,-Absorpt n Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR % DATE o2—,1Z— PERMIT
LOCATION
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME U BUSINESS
NO. BE&ROOMS NO'. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO
AUTO. WASH. MACHINE YES ❑ NO
SITE SUITABLE YES "�J NO
SIZE OF TANK ga .
NITRIFICATION FIELD /S7 sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public
IMPROVEMENTS PERMIT BY c
76
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. 600 Sq. Ft.
Three Bedroom House 900 Gal. 90 Sq. Ft.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
INSTALLED BY Zit v> L S.7-, Ca,
CERTIFICATE OF COMPLETION
By Date R
(8/16/73) *Construction must,c. mply with all other applicable State and local regulations
LOT AREA
I