P293 Mallard RdDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Impi&6mientis Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System G.S. Chapter 130 -Article 13C)
QOWNS OR CONTRACTOR 6 DATE q- 0"%,0 PERMIT
WAD 293
i u i cc �"Tr t
LOCATION ic p1 I To �t P —7- 1 )�c
7" -K-l" I KJ S.R. NO. 1170
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE P5 MOBILE HOME
Ej
BUSINESS 0
House Trailer
800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO.
BATHROOMS
Two Bedroom House
UD-Ga.L. 6D0-Sq,Zt.
GARBAGE DISPOSAL UNIT YES
[3
NO 0
Three Bedroom House
AUTO. DISHWASHER YES
C3
NO ❑
Four Bedroom House
1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES
❑
NO [3
t -i r !, k.4
SITE SUITABLE I % YES
❑
NO
SIZE OF TANK q1D gal.
NITRIFICATION FIELD jig?
sq. ft.
DEPTH OF STONE IN LINES:
P,
WATER SUPPLY: Individual
0
Public [3
IMPROVEMENTS PERMIT BY
-,C1,
INSTALLED BY DliS
5, T.
CERTIFICATE OF COMPLETION
dA-
0
/0 7
y
Date
(8/16/73) *Construction must
cAply with all
other applicable State
and local regulations
LOT AREA