811 Eatons Church 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 DATE j,., S'" PERMIT
T
LOCATION ' r jm "1' l�lO766
f w'
S. R. NO. Elft
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE W MOBILE HOME ❑ BUSINESS ❑
N0. BEDROOMS N0. BATHROOMS
House Trailer
800 Gal. 400 Sq. Ft.
�—
Two Bedroom House
800 Gal.. 600 5�.� Ftp
GARBAGE DISPOSAL UNIT YES. ❑ NO ❑
Three Bedroom House
a 9jr
AUTO. DISHWASHER YES ❑ NO ❑
Four Bedroom Houseellro
.
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK /d?O gal.
NITRIFICATION FIELD < 6 6 o sq. ft.
DEPTH OF STONE IN LINES: '2
WATER SUPPLY: Individual (;' Public ❑
IMPROVEMENTS PERMIT BY
INSTALLED BY
CERTIFICATE OF COMPLETION By �\(;�-�'U
Date J/
(8/16/73) *Construction must omply with all
other applicable State and local regulations
LOT AREA l y""
"/.r"