P511 Carter Rd y DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Lnprovements Permit.and Certificate of Completion
(Ground Absorption Sewage Disposal System- G.S. Chapter .130-Article 13C)
OWNER OR CONTRACTOR 4:t f-1; �` ti�' DATE ' " PERMIT
LOCATION ty `.i - ' . .+ ,r E r.- i` `\CL` �l.....+.. . / _f, No 511
S.R. NO. !k"37
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
? House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS Two Bedroom House 800__Ga1'. 600•--Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House . •-..aaOL..Ga4r. 900 SQ. Ft, ,
AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑ • s ,- -,
SITE SUITABLE YES [3 ` NO ❑ ��J�' ``f i„ - v:
SIZE OF TANK f gal.
NITRIFICATION FIELDG►/, sq. ft.
DEPTH OF STONE IN LINES:
J Z
WATER SUPPLY: Individual d Public ❑ ((tt
IMPROVEMENTS PERMIT BY '+'�' i�'i "` INSTALLED BY C.I 1;s S•'Ti C 0•
CERTIFICATE OF COMPLETION
By `���,�. Date
(8/16/73) *Construction must ccoply with all other applicable State and local regulations
LOT AREA .
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