P879 Spillman, RogerF:I(Ground
DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
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OWNER OR CONTRACTOR c�Gr c C• Y', i I DATE - i-'% ire PERMIT lr
LOCATION ' t : ? 879
S. R. N0.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME 1*3" BUSINESS
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑
SIZE OF TANK X1-1' gal.jr
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ,. Public ❑
IMPROVEMENTS PERMIT BY Q'24t P
CERTIFICATE
(8/16/73)
�pR'�AREA
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
OF COMPLETION BY_S _ _-7 L
*Construction must omply Date
with all other applicable State and local regulations
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