P365 Cana Rd.. A
DAVIE 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 DATE fZZ 7 PERMIT
N° 365
LOCATION %,!
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME �[� BUSINESS ❑
NO. BEDROOMS " 2_ NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK ge) e) gal.
NITRIFICATION FIELD A,/ sq. ft.
DEPTH OF STONE IN LINES: ,<
WATER SUPPLY: Individual r.p Public ❑
IMPROVEMENTS PERMIT BY r• f' _."''- "-^
CERTIFICATE OF COMPLETION By—L
(8/16/73) *Construction must c
LOT AREA
House Trailer
Two Bedroom House SQ(l Gal,
Three Bedroom House 900 Gal.
Four Bedroom House 1000 Gal.
INSTALLED BY
FL,
,`600_ Sq F_t.
00 3q. Ft..,.
1200 Sq. Ft.
J +�'/JCA✓. t..Y,'. �, Date AD "
y with all other applicable State and local regulations