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P284DAVIE COUNTY HEALTH DEPARTMENT sc (Septic Tank) Improvements Permit and ,Certificate .of Completion09 . (Ground Absbrption Sewage Disposal System - G.S. Chapter 130 -Article 13C) OWNER OR CONTRACTOR DATE :;` " .:�" - PERMIT p LOCATION : ,. ' i +.. 2 O 4 t. S.R. NO. SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO. HOUSE Q MOBILE HOME 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 sq. ft. DEPTH OF STONE IN LINES: WATER SUPPLY: Individual ❑ Public ❑ IMPROVEMENTS PERMIT BY House Trailer 800 Gal. 400 Sq. Ft. Two Bedroom House '800-Gal,..6-00-.Sq. Ft. Three Bedroom House: 900 Gal, -r' ?';,900 Sq. Ft--) Four Bedroom House =00 Gal. 1 00 Sq. Ft. INSTALLED BY CERTIFICATE OF OF COMPLETION B" tr %0`�.�,� Date 10-k— (8/16/73) *Construction must Amply with all other applicable State and local regulations LOT AREA