P132 Speaks RdDAVIE COUNTY HE* -DEPARTMENT
(Septic Tank) Improvements Permit. and, C ertificate ,of, Completion
(Ground Absorpttonyy Sewage Disposal System - G.S. Chaptet 130 -Article 13C)
OWNER bR CONTRACTOR '`i:; o .0 c r,` 7 4.4'-. -r— DATE .: " l :i. PERMIT r� cc��
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LOCATION f .c� , ; i:s ti� ,:,,u th4. �� 1 J �i
S.R. NO. IVIVO
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME Q BUSINESS ❑
NO. BEDROOMS NO. BATHROOMS
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GARBAGE DISPOSAL UNIT YES NO ❑�-�
AUTO. DISHWASHER YES .❑.,,r. NO ,
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AUTO. WASH. MACHINE YES 1�c7 NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
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DEPTH OF STONE IN LINES: �' "" l i �.n
WATER SUPPLY: Individual r Public ❑
IMPROVEMENTS PERMIT BY + i"�14
House Trailer 8QD .Gal..,, 40 -0 --Sq•. --Et .
Two Bedroom House 1:800,
Three Bedroom House 900 Gal. 900 Sq. Ft.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
INSTALLED BY Z -f%5 �, j e,40 .
CERTIFICATE OF COMPLETION
ByDate �•,�
(8/16/73) *Construction must omply witth all other applicable State and local regulations
LOT AREA
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