P498 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 ui
DATE - ^� 1�
PERMIT
.,�
N� 498
LOCATION . E'„�,; , -�-
S.R.
NO. /'//0
SUBDIVISION NAME
LOT NO.
SECTION OR
BLOCK NO.
HOUSE ❑ MOBILE HOME
BUSINESS ❑
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO,
AUTO. DISHWASHER YESE NO ❑
AUTO. WASH. MACHINE YES"O NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK qdD gal.
NITRIFICATION FIELD ( sq. ft.
DEPTH OF STONE IN LINES: "
WATER SUPPLY: Individual Puub`liic' ❑
IMPROVEMENTS PERMIT BY %i�/,
House Trailer _anC1»Ga 400 Sq._gt,.
Two Bedroom House 800 66671q,„„�Ftj
Three Bedroom House 900 Gal. 900 Sq. Ft.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
�c:.? t., •"'M< t�. ,.f,) �t iriz' .� ( � 'G� � � ,� r � � 4.-, 1�d G !'i� r
INSTALLED BY r -
CERTIFICATE OF COMPLETION By Date -7' `5 _7 7
(8/16/73) *Construction must Qmply with all other applicable State and local regulations
LOT AREA ”.
.17