P504 Turrentine Church RdDAVIE COUNTY HEALTH DEPARTMENT
• (Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130-A3ttJcle
13C)
OWNER OR CONTRACTOR C Q r\ J Q e�j DATE \fj..'] J PERMIT
LOCATION Y 1\ 504
S.R. NO.
SUBDIVISION NAME
HOUSE 1]' MOBILE HOME
LOT NO.
BUSINESS ❑
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
q m sq. ft.
DEPTH OF STONE IN LINES: a "Ie e,1
WATER SUPPLY: Individual Cl Public ❑
SECTION OR BLOCK NO.
House Trailer 800 .Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. 600 Sq. Ft.
Three Bedroom House °900 Gal � t900 Sq. Ft'.°
Four Bedroom House 1000 Gal. 1200 Sq. -'-PE-.'
IMPROVEMENTS PERMIT BY - + t . LINSTALLED BY IFrarX C -G r r\hnra+
CERTIFICATE OF COMPLETION BYS . rnQ d
Date
(8/16/73) *Construction must omply with all other applicable State and local regulations
LOT AREA
Y
i
}
o0'X3'AQ- A utl
93
�t
1
t �