P213 Dalton Rd DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130-Ar is a 13C)
OWNER OR CONTRACTOR l;7 `+t f'r��„t �tc�rG'^�"$U/� DATE x '7 ERMIT
No21
LOCATION ' ;, ' r ' .. .4,._�._ � �'je* 'YL 3
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS N0. BATHROOMS Two Bedroom House 800 Gaj. 600 SQ. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House 0 00 S Ft
AUTO. DISHWASHER YES Q30' NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES UP-'NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY INSTALLED BY p1�I; �• S;�]-, Lc
CERTIFICATE OF COMPLETION C", Date
BY . ap -
,(8/16/73) *Construction must com6iy with all other applicable State and local regulations
LOT AREA � . Y3.
w w.qW~
.. {yT/� ��• —'nr'YMw..�vy..y'�ry. ,a�gr..wy.��y .
v t
r