P680 Boger, CharlieDAVIE 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 p
LOCATION ; - 6 O O
.-1.. ;. S.R. N0.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOME 0 BUSINESS
NO. BEDROOMS 3_ 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 Cl o- 3 sq. ft.
DEPTH OF STONE IN LINES: i a"
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY
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.
,
INSTALLED BY, ^M ,i t,. :�• t = i -
CERTIFICATE OF COMPLETION
BY ^ t '~ LDate `
(8/16/73) *Construction must comply with all other applicable State and local regulations
LOT AREA
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