P1248DAVIE 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? 1248
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME ❑ BUSINESS ❑
r'
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO 0---
AUTO.
``AUTO. DISHWASHER YES ❑ NO
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES NO ❑
SIZE OF TANK Op gal.
NITRIFICATION FIELD 4az sq. ft.
DEPTH OF STONE IN LINES: ls(��lPYC%
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
800
Gal.
400
Sq.
Ft.
8001_Gal.
1. 600
Sq.
Ft.
900
Gal.
900
Sq.
Ft.
1000
Gal.
1200
Sq.
Ft.
r
INSTALLED BY 'DQ,;,�, 5 f• eu-
CERTIFICATE OF COMPLETION By_ ( � �� � Date 77
(8/16/73) *Construction must c mply with all other applicable State and local egulations
LOT AREA i