P1257 Chinquapin Rd DAVIE COUNTYHEALTH DEPARTMENT
r; (Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorq,tion/S a e Di posal System - G.S. Chapt r ;3.0 rticle 13C)
OWNER OR CONTRACTOR 'z''�» V � c`+f DATE �^' �'' �} PERMIT
LOCATION t'`.f "'✓ r l v�. f lr 125
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME E3 BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS Two Bedroom House 8P0 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO Three Bedroom House 900 Sq. Ft.
AUTO. DISHWASHER YES ( NO )of Four Bedroom Houpe x,100,6 al. 1200 �. Ft.
AUTO. WASH. MACHINE. YES L'"^NO ❑ O C�tr7 -•• =i f t l tti <
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal. `f+� f{ / ',$ .✓, to O's t
NITRIFICATION FIELD sq. ft. 4 0". 0�4.3�1 fV ft
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑ n
IMPROVEMENTS PERMIT BY _141 �.U4'+* ':�-k-" STALLED BY 44• B• �1GVw.r.�-fw W4d•�•
CERTIFICATE OF COMPLETION BY— r (� a� Date 6- 16-77
(8/16/73) *Construction must cohply with all other applicable State and local regulations
LOT AREA s ,' '�. . i�i3 1�, 4 :v "r al/r C off/
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