P1506R
DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate hof Completion
(Ground Absorption Sewage Disposal System'- G.S. Chapte� 130 -Article 13C)
OWNER OR CONTRACTOR 'f
' DATE 7 PERMIT
LOCATION i lr 1506
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUS
HOME ❑ BUSINESS ❑
CERTIFICATE OF COMPLETION '� �1��
BY T L Date
(8/16/73) *Construction must comply with al other applicable State and local regulations
LOT AREA
1
!3a
House Trailer
800
Gal.
400
Sq.
Ft.
N0. BEDROOMS
N0.
BATHROOMS -
Two Bedroom House
800
Gal.
600
Sq.
Ft.
GARBAGE DISPOSAL UNIT
YES
❑
NO ❑
Three Bedroom House
900
Gal.
900
Sq.
Ft.
AUTO. DISHWASHER
YES
❑
NO ❑.
Four Bedroom House
1000
Gal.
1200
Sq.
Ft.
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 '� �1��
BY T L Date
(8/16/73) *Construction must comply with al other applicable State and local regulations
LOT AREA
1
!3a