P1297 Daniel 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 '''" "�w !- �' '-'-'- DATE 1 i� . `7�".` �'` PERMIT
LOCATIONt� r •'
µ 1297
_! j yF E ., �P x.:1.4 -•j"" L'..a :�..,G+' <w.. e`E. 3 G� e
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l i.✓' •per.._ . N0.
SUBDIVISION NAME
HOUSE p MOBILE HOME p BUSINESS
NO. BEDROOMS NO. BATHROOMS
LOT NO. SECTION OR BLOCK NO.
GARBAGE DISPOSAL UNIT YES ❑ NO El
AUTO. DISHWASHER YES ❑,= NO [n
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK /' %" ga1.�
NITRIFICATION FIELD sq. ft
DEPTH OF STONE IN LINES: /o?��
WATER SUPPLY: Individual:,.,❑ Public ❑
IMPROVEMENTS PERMIT BY,/4�-
CERTIFICATE OF COMPLETION
By
(8/16/73) *Construction must comp
LOT AREA',�' fR.'
House Trailer 800 Gal. .400.Sq. Ft.
Two Bedroom House 800 Gal. ) 600_..Sq,_Et:
Three Bedroom House 900 Gal. �_900._Sq..--Ft'.
Four Bedroom House 1000 Gal. /1200 Sq. Ft.
7
INSTALLED BY �� ��
with all other applicable State
r
— Date �"– .2'F'%%
and local regulations