P786 Ebright, ArtDAVIE 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 'tN .,"r Ek� h , +,:; DATE �. _ y . 7 J PERMIT
LOCATION _`]�, i i"t, -, L > .,chi �1. n U + ii�n,i, - ! tet'}tic7 '>_, �.NO (I� p
O6
• )+ S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ® MOBILE HOME ❑ BUSINESS
NO. BEDROOMS
NO.
BATHROOMS
'µ►
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 ❑
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. 600 Sq. Ft.
Three Bedroom House ,� `g00 G'aT'"900 Sq...F
.. _..
Four Bedroom House 'lOOO--Gal. 1200_ — q
Sq. Ft.
IMPROVEMENTS PERMIT BY � ,r ,`,. �� I INSTALLED BY S. l' C--.)•
CERTIFICATE OF COMPLETION By Y��0.�- Date
(8/16/73) *Construction must comjAy with all other applicable Sta
LOT AREA