P527 Wagner 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 t' tt ""` . i . DATE - - 4' ''�S" PERMIT
LOCATION J\ 527
' S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE W MOBILE HOME FLI BUSINESS
N0. BEDROOMS NO. BATHROOMS 1
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD &#n sq. ft.
DEPTH OF STONE IN LINES:/, ,
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY �`4. r•. r. �;�,-r �`
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800._Ga1. 600. Sq.- _Ft.
Three Bedroom House ,.'"900 Gal � X900 Sq Ft,)
Four Bedroom House 1000''Ga1. 1200 Sq. Ft.
INSTALLED BY (r,
CERTIFICATE OF COMPLETION Date q= 9 7S
BY
(8/16/73) *Construction must omply with all other applicable State and local.regulations
LOT AREA,