P1308 No Creek RdDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
}aj �oOWNER OR CONTRACTOR DATE 6 -7 R PERMIT
LOCATION Poc ...�t''i� F..� �,'.(;r,.' 1rr e_ s s= j l�� 1308
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE M MOBILE HOME BUSINESS ❑
NO. BEDROOMS .. NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES (5 NO ❑
AUTO. WASH. MACHINE YES 0' NO ❑
SITE SUITABLE YES E5 NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD 5rD sq.
DEPTH OF STONE IN LINES: I{vc
WATER SUPPLY: Individual C:l Public
IMPROVEMENTS PERMIT BY
ft.
■❑
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
800
Gal.
400
Sq.
Ft.
800
Gal.
600
Sq.
Ft.
900
Gal.
900
Sq.
Ft.
1000
Gal.
1200
Sq.
Ft.
INSTALLED BY ell%s 5 ,-�, L'c,
CERTIFICATE OF COMPLETION
By �{ �Q.•.� o Date /T.2 Gl �?
(8/16/73) *Construction must comply with all other applicable State and local regulations
LOT AREA
A