P83 McKnight RdDAVIE 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 /�(' �P t, .1 J DATE 41 -PERMIT
LOCATION r�� / y.. N .
S[�BDIVISION NAME
HOU
LE
F
.R. NO.
LOT NO. SECTION OR BLOCK NO.
BUSINESS ❑
NO. BEDROOMS s2 NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK �T' D gal. S�-G
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES: h,
w
WATER SUPPLY: Individua l .Public ❑
IMPROVEMENTS PERMIT BY
-.i-
W
•
House Trailer 8Q0_ Gal. 400 Syq. Ft.
Two Bedroom House I KQ_Lar 600 Sq Ft.
Three Bedroom House 900 Gal. '�J-00-5a". Ft.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
INSTALLED BY 4e%t
CERTIFICATE OF COMPLETION By / Date
(8/16/73) *Construction must comp with all other applicable State and local regulations
LOT AREA