P706`i
DAVIE 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 f N? r r�
0 6
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE
LE
BUSINESS
CERTIFICATE OF COMPLETION By 1 Date
(8/16/73) *Construction must1comply with all other applicable State and local regulations
LOT AREA
House Trailer
800
Gal.
400
Sq.
Ft.
NO. BEDROOMS
NO. BATHROOMS
Two Bedroom House
800
Gal.
600
Sq.
Ft.
GARBAGE DISPOSAL UNIT
YES ❑
NO ❑'"
Three Bedroom House
900.Ga1`
;900
Sq
Ft:\
AUTO. DISHWASHER
YES ❑
NO ❑
Four Bedroom House
1000
Gal.
1200
Sq.
F t:`
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 BY
INSTALLED BY
CERTIFICATE OF COMPLETION By 1 Date
(8/16/73) *Construction must1comply with all other applicable State and local regulations
LOT AREA