P586 Calahaln 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 -i1 •., .�', < ��� DATE- / - 7j PERMIT
LOCATION 1.., 1 },)� r",i�� c,r•%lC I t� ,a./ +rye, � �% �ti. fir/:Iif1 � ��• N 506
.? 1w,ttt, e l C k S. R. NO.
SUBDIVISION NAME
HOUSE ❑ MOBILE HOME ® BUSINESS
NO. BEDROOMS P NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal.
LOT NO. SECTION OR BLOCK NO.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Q Public ❑
IMPROVEMENTS PERMIT BY �,•�.- 11^tirt., �r�
i\
CERTIFICATE OF COMPLETION
By
(8/16/73) *Construction must comply with all
LOT AREA J ?. O �(e�
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 8 G,al. 6
Three Bedroom House 900 Gal 900Sq. Ft.
Four Bedroom House 1000 Gal. 1200 Sq. F -t.
INSTALLED BY C-cn-
Date
other applicable State and local regulations
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