653 Duke Whitaker Rd (2) DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
((,round Absorptio Sewage..,Risposal System. G.S. Cha pte 130-Art cle 13C)
OWNER OR CONTRACTOR -e C- DATE -� PERMIT
LOCATION e C :1 ` I' / ?�.. ^*.1 ¢, �� N9 '319
S.R. NO. /.3l
SUBDIVISION NAME LOT N0. SECTION OR BLOCK N0.
HOUSE ❑ MOBILE HOME E3 BUSINESS ❑
House Trailer 80.0 Gal. 400 Sq. Ft.
{ N0. BEDROOMS NO. 'BATHROOMS Two Bedroom House 80 60
GARBAGE DISPOSAL UNIT YES ❑ NO Three Bedroom House ( Ga0 -Ft
AUTO. DISHWASHER YES ❑ NO [ Four Bedrood House Gal. . 1200 Sq. Ft.
AUTO. WASH. MACHINE YES 6-'NO" ❑ ,
SITE SUITABLE YES ❑, NO ❑
SIZE OF TANK /tel) gala`
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual 1 Public ❑
IMPROVEMENTS PERMIT BY t r4 .�' �` - INSTALLED BY
I CERTIFICATE OF COMPLETION B Date 2-
,(8/16/73)
•(8/16/73) *Construction must c6xhAy with all o hpr applicable State and local;-regulat ons
LOT AREA .r�'J'� ^
r
10
L, RO
41
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