P436 Spillman RdDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System G.S. Chapter 130 -Article 13C)
i " �' PERMIT
'OWNERL DATE
—,.,OR CONTRACTOR
LOCATION N9 436
I S.R. NO. Ar [�A,fc�
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE 0 MOBIL
NO. BEDROOMS
GARBAGE DISPOSAL UNIT
AUTO. DISHWASHER
AUTO. WASH. MACHINE
SITE SUITABLE
SIZE OF TANK
NITRIFICATION FIELD
HOME [--] BUSINESS
NO.
BATHROOMS
YES
El
NO
YES
❑
NO
YES
❑
NO
YES
❑
NO
gal.
Now
sq. ft.
r
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
80Q—Gal
40Q. -Sq ---Ft.
900 Gal.
900 Sq. Ft.
1000 Gal.
1200 Sq. Ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public ❑
1
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IMPROVEMENTS PERMIT BY INSTALLED BY r–
1,
CERTIFICATE OF COMPLETION
Bv—r, .9, Di
(8/16/73) *Construction must comWly with all other applicable State and oca]L_Tegulations
LOT AREA
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