P1996 Rosewood LaneDAVIE COUNTY HEALTH DEPARTMENT.
.� (Septic Tank) Improvements Permit and Certificate of Completion'
(Ground-Ab`sorption Sewage Disposal
System - G.S. Chapter, 130 -Article 13C)
OWNER' OR CONTRACTOR % 5 ""a r a'
DATE--.,. /,n ~ F ±; - ' PERMIT.
LOCATION j G`' , .>. ` ±' q ` ,
A �''' �! � �.� y G� � 4 j k: C � . 1� � .
1996
$ S.R. NO.
SUBDIVISION NAME 45t= +Q -cC
LOT NO. SECTION OR BLOCK NO. '
HOUSE.,' MOBILE HOME E3 BUSINESS
❑
-
House Trailer 800 Gal. 400
Sq. Ft.
N0. BEDROOMS NO. BATHROOMS
Two Bedroom House 800 Gal. 600
Sq. Ft.
GARBAGE DISPOSAL UNIT. YES ❑ NO [2r
Three Bedroom House 900 Gal. 900
Sq. Ft.
AUTO..DISHWASHER YES Q` NO ❑
Four Bedroom House 1000 Gal. 1200
Sq. Ft.
AUTO. WASH. MACHINE YES ' C� NO o
f� . = ..
SITE SUITABLE- YES -❑ NO ❑
`
. SIZE `OF TANK gala
NITRIFICATION FIELD sq. ft
a
-OF
DEPTH STONE IN LINES:
...r�. G" : ✓. ".
WATER SUPPLY:. Individual ❑ ..Public ❑
IMPROVEMENTS. PERMIT BY,. ; ;;
INSTALLED BY