P568 Farmington 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 r DATE :1-�' PERMIT
LOCATION 0t • N? 568
i..c ;Y S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE PQ MOBILE HOME t3 BUSINESS ❑
House Trailer 800al. �.-S.c}�.F.t.
NO. BEDROOMS _ NO. BATHROOMS Two Bedroom House ;OOfGal. 600GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑ j / zl y j frl� ' G r
SITE SUITABLE YES ❑ NO ❑ , _
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑ q /:�ct', !'a'�� �+`~.t' •� n.�
IMPROVEMENTS PERMIT BY (_ Y1~�:_a_,.-, �s. INSTALLED BY s • Com'
CERTIFICATE OF COMPLETION .�
�✓�^� Date
(8/16/73) *Construction must c&ply with all other applicable State and local regulations
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