P598 Danner RdDAVIE 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 0 - _ " i.., 3 C_ DATE PERMIT
LOCATION 1 -> 1 �':. Rr iF.'' . i (•, t ,\ , , ., W. % p .� .� �` , c Ql NO
SUBDIVISION NAME
HOUSE
BUSINESS
S .R. N0. /�
LOT NO. SECTION OR BLOCK NO.
•
1�
w?
House Trailer 800 Gal.
400 Sq.
Ft.
NO. BEDROOMS C-
NO.
BATHROOMS
Two Bedroom House 800 Gal.
600 Ft.
GARBAGE DISPOSAL UNIT
YES
El
NO ❑
Three Bedroom House X900 Ga
,,,�qq00 SqF
AUTO. DISHWASHER
YES
❑
NO [3
Four Bedroom House 1000 G
1200—Sq.
Ft.
AUTO. WASH. MACHINE
YES
❑
NO ❑
W 1% sc
SITE SUITABLE
YES
C-1
NO NO ❑
;zdseR�c$
elm
SIZE OF TANK
gal.
O+Vxe R �oMQ �.
NITRIFICATION FIELD
sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual
Q�
Public ❑
IMPROVEMENTS PERMIT BY
L-, _\-,
s�-16
INSTALLED BY 1 -,aN
.f
CERTIFICATE OF COMPLETION By Date �" 3 -71
(8/16/73) *Construction mustT
ply with all other applicable State and local regulations
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