P19 Farmington Rd DAVIE COUNTY HEALTH DEPARTMENT ri' J VSO ti-"'
(Septic Tank) Improvements Permit and Certificate of Completion /
(Ground Absorption Sewage Disposal System - G.S. Chapter- 130-Article 13C)
OWNER OR CONTRACTOR ��itJ•!.r �_-_fir ,d :� r t..,�,�,, s DATE ��. ,�?- '� PERMIT
LOCATION t *. `�r,: �" .,r t°f r f�� �i i�' � NO 19
°--'--r— S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE. ❑ MOBILE HOME BUSINESS ❑
House Trailer 800 Gal.
NO. BEDROOMS.,A 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 Q NO Four Bedroom House 1000 Gala 1200 Sq. Ft.
AUTO. WASH. MACHINE YES NO
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK Pj 0gal.`
NITRIFICATION FIELD to ao sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY , _t • INSTALLED B Q,"t
CERTIFICATE OF COMPLETION 14
gy Date
(8/16/73) *Construction must co wit all other pplicable State and local regulations
LOT AREA I /D l' 3
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