P1355 Hwy 601Nc j DAVIE 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 DATE PERMIT
LOCATION 41ol�!< %,F'.,.1 - �� irf'f NO
SUBDIVISION NAME LOT NO.
HOUSE ❑ MOBILE HOME
,Jj
BUSINESS
NO. BEDROOMS eq NO.
BATHROOMS
GARBAGE DISPOSAL UNIT YES
❑
NO
❑
AUTO. DISHWASHER YES
❑
NO
❑
AUTO. WASH. MACHINE YES
❑
NO
❑
SITE SUITABLE YES ❑
SIZE OF TANK gal.
NO
❑
NITRIFICATION FIELD 4 2 sq. ft.
S. R. NO.
SECTION OR BLOCK NO.
1355
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.
DEPTH OF STONE IN LINES: le If
WATER SUPPLY: Individual ❑ Public �f "4,1
" A
IMPROVEMENTS PERMIT BY V;` oy ,) INSTALLED BY ec
CERTIFICATE OF COMPLETION
BY—
(8/16/73) *Construction must
LOT AREA
Date
ly with all other applicable State and local regulations