141 Liberty Circle DAVIE.COUNTY HEALTH'.DEPARTMENT .
• (Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System -. G.S•:, 130 A�icle 13C)
OWNER OR CONTRACTOR , " ., ,�' '` r �'{d��:tri"y,, �"'DATEPERMIT
11T° 1885
LOCATION
S:R. N0.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK N0.
HOUSE ❑ L MOBILE HOME - BUSINESS ❑
House Trailer 800 Gal 40.0 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS Two Bedro'om',House 800.•Gal . 600 -Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House 900 'Ga1. " . •900 Sq. Ft.
AUTO. DISHWASHER YES ❑. -NO ❑ Four Bedroom House 1000-Gal. 1200. Sq. Ft.
AUTO:. WASH. MACHINE YES ❑ `NO ❑
SITE SUITABLE YES. ❑ `NO Q
SIZE OF TANK gal:
NITRIFICATION FIELD:. sq. ft.
DEPTH OF 'STONE IN LINES: .
WATER SUPPLY: - Individual ' r Public ❑ ,,r t,�
IMPROVEMENTS PERMIT.BY �• - rF INSTALLED BYE
CERTIFICATE OF COMPLETION -711BY r Date
'(8/16/73) *Construction- must comply. with, 11 other applicable State and local regulations. .;• .
LOT AREA