P831 Peoples Creek RdDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
-(Ground Absorption Sewage Disp al System - G.S. Chapter 130 -Article
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OWNER OR COTRACTOR e
. OR TOR ,^� 1 .� ��..z6. c-�..-��� �: j �.:,�, �•;,� DATEPERMIT
LOCATION..
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N° 8 31
S. R. NO. fc.,J O
kSUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE
HOME IH BUSINESS
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AU-tO. DISHWASHER YES NO ❑
AUTO. WASH. MACHINE YES Vii' NO ❑
SITE SUITABLE YES [7; NO ❑
SIZE OF,TANK J4�- gal.
NITRIFICATION FIELD .:>o sq. ft.
DEPTH OF•STONE IN LINES:
WATER SUPPLY: Individual 19 Public ❑
House Trailer 800 Gal.
Two Bedroom House 0"T'da 600 S Ft.
Three Bedroom House 900 Gal. 900 Sq. Ft.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
3 IMPROVEMENTS PERMIT BY �� �` f.A INSTALLED BY rJ �
CERTIFICATE OF COMPLETION By Date Z 1' 7 2
(8/16/73) *Construction must com wit a 1 other applicable State and local regulations
LOT AREA
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