P298 Elmore RdDAVIE COUNTY HEAL''fH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR aT c a ct f� z � DATE PERMITO
N. 298
LOCATION
S. R. NO. .�
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
BUSINESS
NO. BEDROOMS
NO. BATHROOMS
GARBAGE DISPOSAL UNIT
YES ❑
NO
❑
AUTO. DISHWASHER
YES ❑
NO
❑
AUTO. WASH. MACHINE
YES ❑
NO
❑
SITE SUITABLE
YES ❑
NO
❑
SIZE OF TANK �'; 'd�
gal.
NITRIFICATION FIELD
t�(ty
sq. ft..:
DEPTH OF STONE IN LINES: 4,
House Trailer 800 Gal_. 400,_Sq.---F.t.
Two Bedroom House 800 Gal x'600 5:
Three Bedroom House`900 Gal. V900 Sq. Ft.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY ; =ty �rv'�^.._.fin INSTALLED BY �'� I %Te r2 ?03A COO
CERTIFICATE OF COMPLETION ByDate �/-t-
(8/16/73) *Construction must omply with all other applicable State and local regulations
LOT AREA
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