P477 Daniel, ArmandDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
'TGround Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)"'
OWNER OR CONTRACTORr � �a,fs _..- . ' .,ori-'^,� "?. ,f `` DATE 4 r% PERMIT
LOCATION ' '~ '%j := N° 477
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME [7 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 452' gal.
NITRIFICATION FIELD rA3 sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual, Public ❑
IMPROVEMENTS PERMIT BY / •,'a w' n.�.�
House Trailer
800 Gal.
400 Sq.
Ft.
Two Bedroom House
_$QQ Gal.
�QkQ Sg.
Ft.
Three Bedroom House
al
_q.
Ft.3
Four Bedroom House
1000 Gal.
1200 Sq.
Ft.
._INSTALLED BY
W41 To C_ w��n rim
CERTIFICATE OF COMPLETION By �\ ,yi.. r' �,,;•�,�1 ...---- Date
(8/16/73) *Construction must comp y with all other applicable State and local regulations
LOT AREA
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