P503 Turrentine Church 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 DATE 1 - 4 ` %_jr PERMIT
LOCATION i �.e . t : d- . 1 r% a` 503
.r.R. N0.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE lam. MOBILE HOME 0 BUSINESS
NO. BEDROOMS 19, NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK C'?,1 gal.
NITRIFICATION FIELD ..�n,.:::�f,�;�"0 sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BYt5.f
House Trailer 800 Gal. 400..Sq. Ft.
Two Bedroom House x"`$000 Gal '" 00 Sq. Ft.---
Three Bedroom House 500 Gal. 900 Sq. Ft.�
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
INSTALLED BY
CERTIFICATE OF COMPLETION By� �,7�yi it �A Date ��
(8/16/73) *Construction must pomply with all other applicable State and local regulations
LOT AREA
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