P1022 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 1 `_
DATE `. PERMIT
! ~"
N. 1022
LOCATION
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE 0' MOBILE
HOME
❑ BUSINESS ❑
�.G-
House Trailer
800
Gal.
400
Sq.
Ft.
NO. BEDROOMS _
NO.
BATHROOMS
Two Bedroom House
800
Gal.
600
Sq.
Ft.
GARBAGE DISPOSAL UNIT
YES
❑ NO Q-~
Three Bedroom House
900
Gal.
900
Sq.
Ft.
AUTO. DISHWASHER
YES
(l7-• NO ❑
Four Bedroom House
1000
Gal.
1200
Sq.
Ft.
AUTO. WASH. MACHINE
YES
C]'� NO ❑
SITE SUITABLE
YES
❑ NO ❑
SIZE OF TANK
gal.
NITRIFICATION FIELD
sq. ft.
DEPTH OF STONE IN LINES:
lc.✓e1
WATER SUPPLY: Individual
�"� Public ❑
IMPROVEMENTS PERMIT BY
c
r
INSTALLED BY
0
CERTIFICATE OF COMPLETIONBy .;,y �A Date
(8/16/73) *Construction must Amply with all other applicable State and local regulations
LOT AREA r +. e , .. ► 01
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