P1084 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 _ �a m e. S S DATE 2 -2 - % PERMIT
LOCATION _ 6ol _W_ - - 1 �a-, Le re he f`-� e �r \ \,. _ �. hAjc- Fk Vt e N? 1084
S.R.' N0.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE
BUSINESS ❑
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE �-�, YES ❑ NO ❑
SIZE OF TANK:.; 'i f• gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES: �%'r= i.�fai 4-0
WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BY . -
House Trailer
800
Gal.
400
Sq.
Ft.
Two Bedroom House
800
Gal.
600
Sq.
Ft.
Three Bedroom House
900
Gal.
900
Sq.
Ft.
Four Bedroom House
1000
Gal.
1200
Sq.
Ft.
INSTALLED BY
CERTIFICATE OF OOMPLETION BY
Date
`
(8/16/73) *Construction must comp 'witl i'll other applicable State and local regulations
LOT AREA C
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