P596 Hwy 601NDAVIE 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 1 ,:� :,i::«..•.� t z.: s' DATE c ~ :1 �,. i,� PERMIT
LOCATION ! ? �-� . "- :� 1\ ? 596
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k .I "7"�, (, M}t, i ' - -''i'.7. r,/, �s r��.;,i S.R. NO.
SUBDIVISION NAME t / :: rLOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME ❑ BUSINESS ❑
N0. BEDROOMS ' NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
i AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO
SIZE OF TANK t .
ga 1 (P>,4.
.Ian,
NITRIFICATION FIELD �k") sq. ft.
DEPTH OF STONE IN LINES: '�44
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY
r
House Trailer
800 Gal.
400 Sq.
Ft.
Two Bedroom House
800 _Gal.
609-,9.q_._
Ft.
Three Bedroom House
00,x?
�0. Sq,.-,-
Four Bedroom House
�-
1000 Gal.
1200 S�
t.
dam,
INSTALLED BYn� �"�`l �'- �•+ %,f-�-'
CERTIFICATE OF COMPLETION a _ ?
BY Date
(8/16/73) *Construction must com y with all other applicable State and local regulations
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