P291 Childrens Home Rd/Bowman 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 ;tis -i .., �_ ^", DATE •,7- 7,�l PERMIT-
LOCATI( �Ie►'3 i t V-A i 1; 1
a,
i to '= k S.R. NO. I.:,,
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME 91 BUSINESS ❑
NO. BEDROOMS
NO.
BATHROOMS
GARBAGE DISPOSAL UNIT
YES
❑
NO
❑
AUTO.
DISHWASHER
YES
❑
NO
Q'
AUTO.
WASH. MACHINE
YES
NO
❑
SITE
SUITABLEYE
{{�
S
❑
NO
❑
SIZE
OF TANK "f_M-
_ gal.
NITRIFICATION FIELD 0,rr sq. ft.
DEPTH OF STONE IN LINES: (oil
WATER SUPPLY: Individual Rr Public'. ❑
291
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800, Gal. 60Q,_S.q...Yt.
Three Bedroom House 900 Gal,;:`Q(�a,Sg. Fta.:3
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
IMPROVEMENTS PERMIT BY t: Tick,,.,L\) I INSTALLED BY �W N, s
CERTIFICATE OF COMPLETIONa`
BYL'.�cT
(8/16/73) *Construction must c(G Date ply with all other applicable State and local regulations
LOT AREA
t