P71 Spillman 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 <7 {':' DATE 4L—PERMIT
LOCATION �� n! ✓tr.-.�� K., ~` I ay f / N . 71
SUBDIVISION NAME
HOUSE
LE HOME [ BUSINESS
` S.R,/NO.
LOT NO. SECTION OR BLOCK NO.
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 gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual , ❑ Public El
IMPROVEMENTS PERMIT BYE',
House Trailer 800 Gal. 409LSq. Ft.
Two Bedroom House f 800 'Gal. 600Sq. Ft.
Three Bedroom House 900 Gal. 900 Sq. Ft.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
INSTALLED BY ,5.
CERTIFICATE OF COMPLETION t1
gy _ rG` �lla-r� Date
(8/16/73) *Construction must cPmply with all other applicable State and local regulations
LOT AREA tr