P310 Hwy 64EDAVIE COUNTY HEALTH DEPARTMENT
/ (Septic Tank) Improvements Permit and Certificate of Completion
(Ground Ab so tion Sewage Disposal Sy tela - G.S. Chapter 130 -Article 13C)
O INEit 'OR CONTRACTOR Q i �+ C? C=� , t:'b ,17 ',w t i� DATE '~,.�i �- � PERMIT
�.._ No 310
LOCATION 0
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
House Trailer 42"—n 400
N0. BEDROOMS N0. BATHROOMS Two Bedroom House
GARBAGE DISPOSAL UNIT YES El NO ❑ T Three Bedroom House 900 Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES ,❑,_ NO � Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ff,r NO ❑
SITE SUITABLE /� YES [3 NO [3SIZE OF TANK q:.i gal.
NITRIFICATION FIELD 9,1rp sq. ft.
DEPTH OF STONE IN LINES: &
WATER SUPPLY: Individual .n.M—2-ub_Lic ❑
IMPROVEMENTS PERMIT BY
r.JB rA/ J60A .ey
INSTALLED BY J Rg , C- %-r C'D'
CERTIFICATE OF COMPLETION < 1 —
�� gJ-)
By Y,
Date
(8/16/73) *Construction must c6&ply with all other applicable State and local regulations
LOT AREA
44
I