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P595 Jack Booe Rd
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 , ,:,:,"., , rr„ `� j s ! DATEa �' a, r- PERMIT LOCATION i? At .� . `; + it, `i" r' J.;; �s - j rx / • }ii7f • lr O C.3 /tf'}I. r' S.R. NO. �L SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO. 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: 595 House Trailer 800 Gal. 400 Sq. Ft. Two Bedroom House 8,0 -0 ---Gal, - ,� 69.Q..S.q_-F_ . Three Bedroom House 900 Ga - 9_00 Sq. Ft�j Four Bedroom House 100 Gal. 1200 Sq. Ft. WATER SUPPLY: Individual © Public ❑ IMPROVEMENTS PERMIT BY 0, INSTALLED BY i f So CERTIFICATE OF COMPLETION ` % 9—% A -- (8/16/73) —%i- (8/16/73) LOT AREA By Date *Construction must c#ply with all other applicable (State and local regulations t F/