P705DAVIE 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 ` ;' — N? 705
S.R. NO.
SUBDIVISION NAME LOT �NO.{ f�SECTION OR BLOCK NO.
HOUSE ❑ 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 BYt-
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
a
800
Gal.`s.
400
Sq.
Ft .
.. ....._.
800
.-...j
Gal.
600
. _ __
Sq.
_,
Ft.
900
Gal.
900
Sq.
Ft.
1000
Gal.
1200
Sq.
Ft.
INSTALLED BY
CERTIFICATE OF COMPLETION B, Yy-\\[S Date
(8/16/73) *Construction must c mply with all other applicable State and local regulations
LOT AREA t;,{. X.
7a'