P925 Baity RdDAME COUNTY HEALTH DEPARTMENT P1 11 kf__i3� P414
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal Sys em - G.S. Chapter 130 -Article 13C).
OWNER OR. CONTRACTOR-. % j �'.`' ; DATE '.' '/ / PERMIT
LOCATIONlr 9 925
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SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME U; --'-'BUSINESS ❑
NO. BEDROOMS _ NO. BAT
HROOMS
GARBAGE DISPOSAL UNIT YES NO - D --*'AUTO. DISHWASHER YES
AUTO. WASH. MACHINE YES W --;NO ❑
SITE SUITABLE YES Y NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD_} r. 0r,,tAl4! sq. ft.
DEPTH OF STONE IN LINES:,�• -,�tt; - Avc
WATER SUPPLY: Individual Q ublic ❑
IMPROVEMENTS PERMIT BY � .01'�;,.a.• ;�., .Y.,�•:
House Trailer 800 Gal.
Two Bedroom House 800 Gal.
Three Bedroom House 900 Gal.
Four Bedroom House 1000 Gal.
INSTALLED BY 6 •- 13AII T
CERTIFICATE OF COMPLETION
BY
(8/16/73) *Construction must comply with all of
LOT AREA
400 Sq. Ft.
600 Sq. Ft.
900 Sq. Ft.
1200 Sq. Ft.
Date R 7
p licable State and local regulations
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