1037 Sheffield RdDAVIE COUNTY-VHE4LTH 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 N? 694
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ® MOBILE HOME BUSINESS ❑
NO. BEDROOMS 7, NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES 0 NO ❑
SIZE OF TANK gal.�,�, ,0
NITRIFICATION FIELD A0 0 sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. 600 Sq. Ft.
Three Bedroom House 900 Gal": 90fJ Sqn. "'Ft:,
Four Bedroom House 1000 Gal. 12"00'Sq:`"
IMPROVEMENTS PERMIT BY \ I INSTALLED BY C,.1}t
CERTIFICATE OF COMPLETION By— t t + �.� 4— _ Jf- 1
(8/16/73) *Construction must
LOT AREA '1 f), .
r Date r .
with all other applicable State and loc4l regulations