P956 Rhynehart RdDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) -,'Improvements Permit and Certificate of - Completion
(Ground Absorption Sewage DisposalSystem-,G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR DATE_`^-, 5�
r ;,�, PERMIT
LOCATION '�_ ��`` - -f s.j" ,'; ` r; f .-;.; f _ .' [.1 .� e.��i/�t+`� 956
-.. �XR.' N0: �
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
NO. BEDROOMS r
.� N0. THROOMS
GARBAGE DISROSAL UNIT YES ❑ NO
AUTO. DISHWASHER YES ❑ NO ( "
AUTO. WASH..MACHINE YES a°'`rN0 ❑,
SITE SUITABLE ' YES ❑ NO "br
SIZE OF TANK qt -)I) gal.
r
NITRIFICATION FIELD Ir !~ /) sq. ft.
DEPTH OF STONE IN LINES: �' 1
WATER SUPPLY: Individual G Public ❑
IMPROVEMENTS PERMIT BYr ,, i --,•, ,.
CERTIFICATE,OF COMPLETION
By—
(8/16/73) *Construction must
LOT AREA
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i
7 / f
House Trailer
800 Gal.
400 Sq. Ft.
Two Bedroom House
800 Gal.
600 Sq. Ft.
Three Bedroom House
900 Gal.
900 Sq. Ft.
Four Bedroom House
1000 Gal.
1200 Sq. Ft.
,
INSTALLED BY,_�,�',�
/I- Date �G %
y with all other applicable State and local regulations
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