P591 Sheffield RdDAVIE 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 '�,w.,..11 _ � �: •: ; ..-�DATE J:, -17-7.5 � PERMIT
LOCATION I,','t r !. Sh`,, `.'`"'"""rr_� .�e .- __ •- .._- N° 591
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SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME p 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 o gal. ' -, 0�
NITRIFICATION FIELD _ !� sq. ft.
DEPTH OF STONE IN LINES: �S �J Ea
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY •�.� �.,� {r :�. __.,� a
.
CERTIFICATE OF COMPLETION
By
(8/16/73) *Construction must cc
LOT AREA
t3 C4
House Trailer 800 Gal., 400 Sq. Ft.
Two Bedroom House 8000—Ga 600 Sq. Ft.
Three Bedroom House (--9'00 Gal. 6TO Sq. Ftp
Four Bedroom House 1200 Sq. Vit.
INSTALLED - BY
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with all other applicable State and local regulations
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