P709 Bracken RdDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130-Artic a 13C)
OWNER OR CONTRACTOR ~ �66� DATE _ PERMIT
LOCATION N? 709
9
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME Ej BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House 900"6all F900 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 00 gal. '
NITRIFICATION FIELD ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BY INSTALLED BY
CERTIFICATE OF COMPLETION
By -
(8/16/73) *Construction must
LOT AREA
Date
with all other applicable State and local regulations
�F1411,1 IYe �,.R 3
W10
F4'tmL-r15 T7arn�
r l ZZ« j/v s7,F