P1347 Hwy 158DAVIE 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 . ��, ; , v; c: ,..s <; DATE 05
PERMIT
N° 1347
LOCATION •��T"t-1,y r t._ s; �:s r5° f' iY1.,�_ `-t ,�� c,` f, •c!'-
S.R.
NO.
SUBDIVISION NAME LOT NO. SECTION OR
BLOCK NO.
HOUSE MOBILE HOME BUSINESS ❑
3
House Trailer 800
Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS
Two Bedroom House 800
Gal. 600 Sq. Ft.
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 ❑
SIZE OF TANK ii••U gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ft. -,
Public ❑
IMPROVEMENTS PERMIT BY Q)p,;,Q
r
INSTALLED BY
Date���-� �
CERTIFICATE OF COMPLETION By___ _r�
(8/16/73) *Construction must c ply with all other applicable State and
local regulations
LOT AREA ;�t':sl�' r�/.':
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