P482 Greenhill RdA. DAVIE COUNTY HEALTH—DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground*Absorp!.*on Sewage Dispos)il,,Sy�tem G.S. Chapter 130-ArtiG,le'3 c
OWNER OR CONTRACTOR DATE PERMIT1 iia r
LOCATION
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE /U. MOBILE HOME U BUSINESS
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT
YES
0
NO
0
AUTO.
DISHWASHER
YES
El
NO
❑
AUTO.
WASH. MACHINE
YES
0
NO
❑
SITE
SUITABLE
YES
[3
NO
[3
SIZE
OF TANK
gal.
NITRIFICATION FIELD
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual
IMPROVEMENTS PERMIT BY
CERTIFICATE OF
(8/16/73)
LOT AREA
sq. ft.
is 0
By C /
*Construction must comply with all o
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.
7f
INSTALLED BY
/f I Date 6, - - 7 -V'
pplicable State and local regulations