P329 Pine Ridge RdDAVIE COUNTY HEALTH DEPARTMENT
,; (Seotic_Tank). Improvements Permit and Certificate of ,Completion,
(Ground Absor tion Swage Dispo al System - G.S. Chapty 130 -Article 13C)
OWNER OR CONTRACTOR 'r�-r ^: e fa, DATE € " "r /PPERMIT
LOCATION 7 t:"` r : L-� f c: ,,a . ..,.. ....• a NO� 329
•
F S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME ,jam BUSINESS
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 /00,0 gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF..,S_TQNE"IN LINES: ,"
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY ` ` _ ~MrA.I
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House t80U.Qa,l, ct„.I.Ft.
Three Bedroom House (,LQ�, ,] 900 SESJ
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
e � r
a.
INSTALLED BY
CERTIFICATE OF COMPLETION 7*56
BYDate zr
(8/16/73) *Construction must 8gmply with all other applicable State and local regulations
LOT AREA
a.�..—
� lie
rryM.rrs.
:5
0