P1838 Hwy 601SDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption pSwage Disposal System - G.S. Chapter 130- rticle 13C
OWNER OR CONTRACTOR �N�ti z� .�� /j DATE / %� PERMIT
LOCATIONI--+r wn c _ _~7 [/Zj 7 :7�-~� r�;--r-J� rr L2_ t��- �� 1838
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE
HOME
❑
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
gal.
NITRIFICATION FIELD
sq. ft.
DEPTH OF STONE IN LINES:
U u /, T! L --
WATER SUPPLY: Individual
❑
ublic ❑
IMPROVEMENTS PERMIT BY
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 1'•, . , 'lDate - ;'�
(8/16/73) *Construction must comply with all Cher applicable State and local` egulations
LOT AREA