P845 Turrentine Church Rd. - DAVIE 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 S -Q �TYl ,`i,/�� Y— DATE
PERMIT
LOCATION / 2< 1�=� '" ea / ' . € n r r r * f ' ��► r� fx .. ��O# �' r c% /F1 �. - l� � 845
t5141 /It ,�,�� /' rr>tr, 3c' c`,,,, tj ,F Q1. .*' S.R. N0.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME ❑ BUSINESS ❑
NO. BE4R6OMS *�.�' NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO O
AUTO. DISHWASHER YES ❑ NO r
AUTO. WASH. MACHINE YES ❑ NO
SITE SUITABLE YES-- NO t .�
SIZE• OF TANK '91,00gal[
NITRIFICATION FIELD a sq. ft.
DEPTH OF STONE IN LINES: !A 'for
WATER SUPPLY: Individual Public ❑
%IMPROVEMENTS PERMIT BY
House Trailer
800
Gal.
400
Sq.
Ft.
Two Bedroom House
800
Gal.
600
Sq.
Ft.
Three Bedroom House
900
Gal.
900
Sq.
Ft.
Four Bedroom House
1000
Gal.
1200
Sq.
Ft.
INSTALLED BYtl ��."r�. •
CERTYFICATE OF COMPLETION V `'-" % X1,5`
f,.
By M. ; �- _. Date `Y
(8/16/73) *Construction must comp].cy'with all other applicable State and local regulations
LOT AREA