P1024 Fairfield Rda
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 '''J ' ' i DATE yl- PERMIT
i
LOCATION / - !- ' 9 1024
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME
BUSINESS ❑
a
Date - r ` I %.
*Construction must Amply
House Trailer 800 Gal. 400 Sq. Ft.,<>`'
NO. BEDROOMS _ NO.
BATHROOMS
Two Bedroom House 800 Gal. 60.0....5 Ft.
q `�
GARBAGE DISPOSAL UNIT YES
❑ NO ❑
Three Bedroom House 900 Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES
❑ NO ❑
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES
❑ NO ❑
SITE SUITABLE YES
❑ NO ❑
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SIZE OF TANK 1 6D gal.
NITRIFICATION FIELD
sq. ft.
DEPTH OF STONE IN LINES: " ,�i if,,( ��, , "'', 4`�.
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WATER SUPPLY: Individual
Public ❑
ay.4 . `.,� ��t j rc)1. t ,, ��;�; •,y �,
IMPROVEMENTS PERMIT BYINSTALLED
BY
CERTIFICATE OF COMPLETION
(8/16/73)
AOT, AREA
t�
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By
ev
Date - r ` I %.
*Construction must Amply
with all
other
applicable State and local regulations
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