P661DAVIE 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 ... DATE PERMIT
LOCATION 661
SUBDIVISION NAME 'i),-,.
LOT NO. SECTION OR BLOCK NO.
HOUSE 0 MOBILE
BUSINESS El
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES 0 NO C-1
AUTO. DISHWASHER YES (Z] NO 0
AUTO. WASH. MACHINE YES 0 NO 0
SITE SUITABLE YES [Z) NO ā
SIZE OF TANK gal. J-14)
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES.i
WATER SUPPLY: Individual 0 Public N
IMPROVEMENTS PERMIT BY
House Trailer 800 Gal. 400 Sq. Ft.
-y -
Two Bedroom House ---"-800'Ga'lā600 Sq.
Three Bedroom House 900Uii
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
1. tj
INSTALLED BY
CERTIFICATE OF COMPLETION
By Date
(8/16/73) *Construction must comoy with all other applicable State and local regulations..,
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LOT AREA `0 a s..F6o
f.
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