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P246 Hwy 64EDAVIE 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 ?;'' w: Vit' }t "<��" DATE s - y PERMITO N. 246 LOCATION 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 g (I sq. ft. DEPTH OF STONE IN LINES: WATER SUPPLY: Individual,- Public ❑ IMPROVEMENTS PERMIT BYi House Trailer Two Bedroom House Three Bedroom House Four Bedroom House INSTALLED BY 80 L .. Ft -t Lau-" .S.4--F.trj� 900 Gal. 900 Sq. Ft. 1000 Gal. 1200 Sq. Ft. CERTIFICATE OF COMPLETION :?-//- % V gy VN- a..TQ _,- Date (8/16/73) *Construction must comply with all other applicable State and local regulations � s d LOT AREA 1` F f i f i t i F a' f Y * 1 t7 F N ' s