P247 Hwy 601SDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorpt-ton Sewpge Disposal System - G.S. Chapter 130 -Article 13C)
ER OR CONTRACTOR tt ``�,''1.j 1:" ^'!�� -''. DATE , PERMIT
No
LOCATION
SUBDIVISION NAME
f1l S. R. NO.
LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME M BUSINESS ❑
NO. BEDROOMS NO. BATHROOMS -.-
GARBAGE DISPOSAL UNIT YES ❑ NO ❑—
AUTO. DISHWASHER YES ❑ NO (2-'
AUTO. WASH. MACHINE YES [9'0',NO ❑
SITE SUITABLE YES (0' NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual,) Public ❑
IMPROVEMENTS PERMIT BY
-1 247
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. 600�Sq.Ft.
Three Bedroom House +„ 900 900 S . Ft.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
INSTALLED BY J�,jf k C��F�,ti
CERTIFICATE OF COMPLETION
gy7QV�owc Date"!tt 7s,(8/16/73) '*Construction must comply with all other applicable State and local regulations
LOT AREA
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