P1123 Bracken RdDAVIE 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 i�4� ��� DATE J'-�� PERMIT
LOCATION
HOUSE
N° 1123
LQY747 4 �e /P_�t S.R. N0. /S14?
VISION NAME,�_LOT N0. SECTION OR BLOCK NO.
r----r-�-+-r--
SINESS
NO. BEDRO&S +�- 3 NO " THROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO
AUTO. DISHWASHER YES[
g>N0
NO ❑
AUTO. WASH. MACHINE YES 0r.1SITE SUITABLE YES ❑
SIZE OF TANK 26,p gal.
NITRIFICATION FIELD 2-0 sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual X Public ❑
IMPROVEMENTS PERMIT BY
CERTIFICATE OF COMPLETION
By
(8/16/73) *Construction must comp
LOT AREA
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
INSTALLED BY
800
Gal.
400
Sq.
Ft.
800
Gal.
600
Sq.
Ft.
900
Gal.
900
Sq.
Ft.
1000
Gal.
1200
Sq.
Ft.
/1J�-t.•�-Q� Date1f �!
th all other applicable State and local regulations
` DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption /Sewa a Di s osal System - G.S. Chapter 30 -Art cle 13C)
OWNER OR CONTRACTOR / ! Q2 DATE " _a PERMIT
LOCATION N° 1123
» . 41�/Ffi„ S.R. N0. IVI&
SU IVISION NAME - , LOT NO. SECTION OR BLOCK NO.
HOUSE
N0. BE d MS 1.....+ N0. BATHROOMS .
GARBAGE DISPOSAL UNIT YES ❑ ,NO ❑"X
AUTO. DISHWASHER YES ❑'r •NO ❑
AUTO. WASH. MACHINE YES ( —NO ❑
SITE SUITABLE YES 0''f NO ❑
oo
SIZE OF TANK 3 gal. '°�'
NITRIFICATION FIELD '; sq. ft.
DEPTH OF STONE IN LINES:'•`
WATER SUPPLY: Individual, Public ❑
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. 600 Sq. Ft.
Three Bedroom House 900 Gal. 900 Sq. Ft.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
97
IMPROVEMENTS PERMIT BY INSTALLED BY1"'.�r'?�fiSfa°' o
=-r
CERTIFICATE OF COMPLETION By w ` Date
(8/16/73) *Construction must comply4fith all other applicable State and local regulations
LOT AREA