P974 Richie RdR
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DAVIE COUNT' HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal m - G.S. Chapter 130 -Article 13C) a'
OWNER OR CONTRACTOR r, i .y DATE, - :j?., PERMIT- r
LOCATION ", i' 6,4111,�W�_,t�;i.) N? 9 / 4
SUBDIVISION NAME
HOUSE ❑ MOBILE HOME,
BUSINESS ❑
NO. BEDROOMS NO. BATHROOMS _
GARBAGE DISPOSAL UNIT YES ❑ NO Cil
AUTO. DISHWASHER YES ,❑ NO Q
AUTO. WASH. MACHINE YES Com• 0 ❑
SITE SUITABLE /'4VO YES NO
SIZE OF TANKVim=^ gal.
NITRIFICATION FIELD S sq. ft.
DEPTH OF STONE IN LINES: . f Vy-
WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BY a'
CERTIFICATE OF COMPLETION
BY -
(8/16/73) *Construction must
LOT AREA
.R. NO.
! SECTION OR BLOCK NO.
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. 600 Sq. Ft.
Three Bedroom House 9,00 Gal. 900 Sq. Ft.
Four Bedroom' House 1000 Gal. 1200 Sq. Ft.
<`'`,/r
r-�
/vLa".G44 ,.
INSTALLED BY 6/, 4'=
/ ��� ��C,r--L_ Date � �-- �-
wi—tall other applicable State and local regulations