P711 Poplin, Thomas~ DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorptio Sewage Dis sal System G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR DATE PERMIT
LOCATION N? r r�
1 1
S. R. NO.
SUBDIVISION NAME
LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME [j 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. <�4�
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BY
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
800
Gal.
400
Sq.
Ft.
800
Gal.
600
Sq.
Ft.
i'900
Gall
900'
Sq.
'Ft.'�,
1000
Gal.
1200
Sq.
Ft.
i
INSTALLED BY
CERTIFICATE OF COMPLETION
i,
gy ir, Date
(8/16/73) *Construction must c p-1j.,with all other applicable State and local regulations
LOT AREA