P545 Murphy 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 DATE - PERMIT
LOCATION ?il !ice' d" . t c %'"Yl aar•. i 2: t %� %+ +� O 545
S.R. NO. 1;?otx
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOU
LE
BUSINESS
NO. BEDROOMS __S
NO.
BATHROOMS
GARBAGE DISPOSAL UNIT
YES
❑
NO
MY
AUTO. DISHWASHER
YES
❑
NO
Q'
AUTO. WASH. MACHINE
YES
V
NO
❑
SITE SUITABLE
YES
❑
NO
❑
SIZE OF TANK
gal.
NITRIFICATION FIELDsq. ft.
DEPTH OF STONE IN LINES: (,`e
WATER SUPPLY: Individual Q Public ❑
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. 69.0 _Sq, F -t_,
Three Bedroom House C 900 Gal,' /9.00 SqFt. '
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
IMPROVEMENTS PERMIT BY..a ;., 1 : I INSTALLED BY
CERTIFICATE OF COMPLETION By Date
(8/16/73) *Construction must conply with all other applicable State and local regulations.
LOT AREA
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