P1166 Howardtown RdDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
NO.
(Ground Absorption Sewage Disposal
System
- G.S. Chapter 130 -Article
13C)
OWNE OR CONTRACTOR I'j f IiL.
❑
DATE �` a�' l C��
PERMIT
I
LOCATION �-�.`�.�trr•c:l`�[,'.::.sr\ .�{..i.r�c'..� � �_.t�;i1
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N 1166
YES
C
S.R.
NO.
SUBDIVISION NAME
LOT NO.
SECTION OR
BLOCK NO.
BUSINESS ❑
NO. BEDROOMS s
NO.
BATHROOMS .2
GARBAGE DISPOSAL UNIT
YES
❑
NO
❑
AUTO. DISHWASHER
YES
[3'
NO
❑
AUTO. WASH. MACHINE
YES
C
NO
❑
SITE SUITABLE
YES
❑
NO
❑
SIZE OF TANK
gal.
NITRIFICATION FIELD
sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual
`
Public ❑
House Trailer 800 Gal.
Two Bedroom House 800 Gal.
Three Bedroom House 900 Gal.
Four Bedroom House 1000 Gal.
400 Sq. Ft.
600 Sq. Ft.
900 Sq. Ft.
1200 Sq. Ft.
IMPROVEMENTS PERMIT BY ` f-, 4r I INSTALLED BY,�
CERTIFICATE OF COMPLETION
cDate
(8/16/73) *Construction mus co'�mply/ other applicable State and oc4t)x4crlki-- -�,
LOT AREA jz "�Y rfU� U•� ll �,•.�,�. chi %?�!? r:r �j tr:ni4
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