P390 Hwy 801SDAVIE COUNTY HEALTil DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR DATE -'t _ -PERMIT
N
LOCATION
N
9
390
r S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME ❑ BUSINESS ❑
NO. BEDROOMS N0. BATHROOMS -
GARBAGE DISPOSAL UNIT YES ❑ NO
AUTO. DISHWASHER YES [:3, NO
AUTO. WASH. MACHINE YES C)' NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD /rr, ?) 0 sq. ft.
DEPTH OF STONE IN LINES: /J,
WATER SUPPLY: Individual .b r Public ❑
IMPROVEMENTS PERMIT BY
House
Trailer
800
G,_a_1.,.
400y.Sq.__Ft.
Two Bedroom
House
1,,800._
Gal.
Three
Bedroom House
900
Gal.
900
Sq.
Ft.
Four
Bedroom House
1000
Gal.
1200
Sq.
Ft.
INSTALLED BY
CERTIFICATE OF COMPLETIONBy,r.. Date
(8/16/73) *Construction must c ply with all other applicable State and local regulations
LOT AREA
Z.