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P82 Hwy 601S
DAVIE COUNTY HEALTH DEPARTMENT (Septic Tank) Improvements Permit and Certificate of Completion (Ground Absorption Sewageisposal System - G.S. Chapter 130 -Article 13C) OWNER OR CONTRACTOR ;'�: 6 � ,� M:� DATE —').PERMIT 7 LOCATION i7 / A- �c f� / f u c C./errs �7 f . e+ .�t S. R. NO. SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO. HOUSE ❑ MOBILE HOME BUSINESS ❑ House Trailer 800 Gal. 400 Sq. Ft. N0. BEDROOMS NO. BATHROOMS 600 Sq. Ft. Two Bedroom House&900ft GARBAGE DISPOSAL UNIT YES ❑ NO"s Three Bedroom House 00 Sq. Ft. AUTO. DISHWASHER YES ❑ NO Q--"'" Four Bedroom House 1000 Gal. 1200 Sq. Ft. AUTO. WASH. MACHINE YES [50 NO E --)SITE SUITABLE YES ©" NO ❑ SIZE OF TANK gal. NITRIFICATION FIELD 9 oU sq. ft. DEPTH OF STONE IN LINES: WATER SUPPLY: Individual $Public ❑ IMPROVEMENTS PERMIT BY/G%.t-'=-r2,. INSTALLEDBY CERTIFICATE OF COMPLETION BY (8/16/73) *Construction must comply,ith all other applicable State and local regulations 71 LOT AREA 1 i"2 rte'` V