P1204 Pleasant Acre DrDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR DATE s - PERMIT
LOCATION �' r / •; - ' r ! ' . ' t c t. 1204
r S.R. NO. ;Z
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
' Ile
HOUSE MOBILE HOME ❑ BUSINESS ❑
NO. BEDROOMS , NO. BATHROOMS _
GARBAG DISPOSAL UNIT YES ❑ NO 0'
AUTO. ISHWASHER YES ❑ NO
AUTO. WASH. MACHINE YES Q NO ❑
SITE SUITABLE YES I3 NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD _" sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual,,., ❑ Public
IMPROVEMENTS PERMIT BY
CERTIFICATE OF COMPLETION
BY—
(8/16/73) *Construction must
LOT AREA
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. 600 Sq. Ft.
Three Bedroom House 900 Gal. 900 Sq. Ft.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
INSTALLED BY J \'�-�
-%!P
' Date
ply with all other applicable State and local regulations
6