125 W Robin Drive Lot 3DAV IE 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�A ' ��, CQ e-,1 _ DATE -� . •;' : •PERMT
�IT
LOCATION "y'- W .e�.� tab n 'D ► r.e l� ? 529
S.R. NO.
SUBDIVISION NAME Rj.)&fAI f J, c 1 --;I- �„^ LOT NO. SECTION OR BLOCK NO.
HOUSE �O MOBILE HOME tj BUSINESS ❑
NO. BEDROOMS
NO.
BATHROOMS
GARBAGE DISPOSAL UNIT
YES
❑
NO
❑
AUTO. DISHWASHER
YES
❑
NO
❑
AUTO. WASH. MACHINE
YES
❑
NO
❑
SITE SUITABLE
YES
❑
NO
❑
SIZE OF TANK
gal.
NITRIFICATION FIELD
DEPTH OF STONE IN LINES:
sq. ft.
WATER SUPPLY: Individual Public
IMPROVEMENTS PERMIT BY
CERTIFICATE OF COMPLETION By
(8/16/73) *Construction must comp
LOT AREA
R,*
E
A
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. 600_S4..__Ft.
Three Bedroom House990—Gal. 900 Sq. Ft
Four Bedroom House 'nb0 Gal. •200 Sq. Ft.
INSTALLED BY 0 / ' �A/L.�- 7, f
Date
th all other applicable State and local regulations
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