P384 Fairfield RdDAVIE COUNTY HEALTH. DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
J PERMIT
OWNER OR CONTRACTOR DATE
LOCATION N? 384
S.R. NO. / W10
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE
BUSINESS
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES El NO 0
AUTO. DISHWASHER YES 0 NO 0 --
AUTO. WASH. MACHINE YES 0- NO 0
SITE SUITABLE YES [3 NO 0
SIZE OF TANK 7 gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public 0
IMPROVEMENTS PERMIT BY 9:�
INSTALLED BY /J-rq
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 8,00 Gal,, _AQQ
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Three Bedroom House Gal.' t,,
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
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CERTIFICATE OF COMPLETION By
(8/16/73) *Construction must comp
LOT AREA
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07 —2 Y,
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'7with all other applicable State and local regulations
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