P748 Chinquapin Rd DAVIE COUNTY HEAUji DEPARTMENT
(Septic.Tank ..Improvements ,Permit and-Certificate of Completion
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(Ground»-Absorption,,•Sewage Disposal System - G.S. Chapter 130-Article.;13C4,,-.-
OWNER OR CONTRACTORrsJ ?,
DATE/ -^- �, p PERMI TT
LOCATION 'S : .`"� 748
�. S.R. NO.
' SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE , � MOBILE HOME 0 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 [�'j' Three Bedroom House 9" 0 Ga 0 ':..
Four. Bedroom. House 1M a _
AUTO. DISHWASHER -` AYES ❑ NO Q '"' . . 1�'0Q"'S"c�".""`P"f
AUTO. WASH. MACHINE; YES [2:`� NO (]
SITE SUITABLE YES.:.'❑ NO [3 ,
SIZE OF TANK gala
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: . Individual', W Public- ❑ r
IMPROVEMENTS PERMIT BYINSTALLED BY
i
CERTIFICATE .OF COMPLETION
By • Date
(8/16/73)`., *Construction must comply with alY o0V r applicable State and local regulations
LOT :AREA r 0.±,