P192 Milling RdDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion --
r(Ground yAbsorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)�
OWNER OR CONTRACTOR n I'Ti n-,
DATE . a 7 PERMIT
LOCATION
SUBDIVISION NAME
BUSINESS
S. R. NO.
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:
WATER SUPPLY: Individual
>lic ❑
192
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 a1. 600 Sq. Ft.
Three Bedroom House N- 00 00 Sq. Fi)
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
IMPROVEMENTS PERMIT BY 1,; j�,".' ✓ i j X -17 -0 -OC -01" i I INSTALLED BY
CERTIFICATE OF COMPLETION e 0
(8/16/73)
LOT AREA
Y ate
*Construction must comply with all other applicable State and local regulations
i �.