P332 Farmingtont •'- a
4k DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposa system - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR`-^�°h :}'r �%f +"i A;/f.t '-fi' DATE"t--f• p� / i PERMIT
LOCATION ► o v p r'<: l r.; ;•i r'' i * ,` /.I; .::.� �`.�i•'1 %[' � t+:.�'t ►'" if/+, +� �'
S.R. NO.
SUBDIVISION NAME
.HOUSE
BUSINESS
LOT NO. SECTION OR BLOCK NO.
NO. BE6ROOMS
NO.
BATHROOMS
GARBAGE DISPOSAL UNIT
YES
❑ NO
800
AUTO. DISHWASHER
YES
❑ NO,
Three Bedroom House
AUTO. WASH. MACHINE
YES❑
0
❑''
SITE SUITABLE
YES
&' NO
❑
SIZE OF TANK
gal.
NITRIFICATION FIELD
-V-'
,Jd
sq. ft.
DEPTH OF STONE IN LINES:
t
332
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.
WATER SUPPLY: Individual Publi ❑
IMPROVEMENTS PERMIT BY 4n INSTALLED BY
CERTIFICATE OF COMPLETION r
BY
(8/16/73) *Construction must cotVly with all other applicable,State and local regulations
LOT ,AREA J �? ►� iJ ?C .$ �C / C. Jj
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