P647 Howell Rd DAVIE 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 '.3 ,A_Aj DATE -7 - 2r„- 7I,, PERMIT
LOCATIONS �.�►� �., ri N° 647
,• r S.R. 140. - t-��
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
House Trailer 800 Gal. •400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ( + Three Bedroom House 900 Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES ❑ NO [ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES 69"''NO 0
SITE SUITABLE YES [D-`" NO ❑
SIZE OF TANK 8a1.
NITRIFICATION-FIELD r.e-n sq. ft. '
DEPTH OF STONE IN LINES: k ,w4
WATER SUPPLY: IndividualPublic ❑ r
IMPROVEMENTS PERMIT BY .r .� P INSTALLED BY %"%c /; �f�...�._�_ •.ti�. ''
CERTIFICATE OF COMPLETION By. Date 21— )/p
(8/16/73) *Construction must co ply/faith ahl other applicabTe`-State and local regulations
LOT AREA
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