P434 Hwy 601SDAVIE COUNTY HEALTH DEPARTMENT
•ft (Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System- G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR +�+ �. ' : ~ = 5 DATE "N PERMIT
LOCATION ( f s 1 ;'s, 1, ;� ti.� a,.,.,�c N9 434
S. R. NO.
SUBDIVISION NAME
BUSINESS
NO. BEDROOMS NO. BATHROOMS
LOT NO. SECTION OR BLOCK NO.
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO E3SIZE OF TANK �� gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:'
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. 600.--Sq,.-..F,t..
Three Bedroom House !900 Gals:` • 900�ScS.. rFt.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
INSTALLED BY
CERTIFICATE OF COMPLETIONBy CJ ,�,-�.,� _,� Date
(8/16/73) *Construction must compl with all other applicable State and local regulations
LOT AREA
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