P826 Four Corners Rdr 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 CONTRACTORs .., , J r^ ,�, ,, r f, - DATE ,2- PERMIT
LOCATION .•, 826
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE
BUSINESS
NO. BEDROOMS _ NO. 'BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO EM
AUTO. DISHWASHER YES ❑ NO
AUTO. WASH. MACHINE YES ❑ NO -
SITE SUITABLE YES ❑ NO
SIZE OF TANK /', rt �n_ gal. '
NITRIFICATION FIELD n sq. ft.
DEPTH OF STONE IN LINES: 4-7 M
WATER SUPPLY: Individual ]' Public ❑
IMPROVEMENTS PERMIT BY
House Trailer
800 Gal.
400 Sq.
Ft.
Two Bedroom House
800 .
600 Sq.
Ft.
Three Bedroom House
Ga
Gal.
900 Sq.
Ft.
Four Bedroom House
1000 Gal.
1200 Sq.
Ft.
r
„I
INSTALLED BY ;',t
CERTIFICATE OF COMPLETIONBy `=! \�� / _., 1:: Z/ Date
(8/16/73) *Construction must compj�,/with all other applicable State and local regulations
LOT AREA