P1897 Deadmon Rd DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewa a is osal System - G.S.P 8 ,..A P y Chapter 130-Article 13C)
OWNER OR CONTRACTOR C l a I i n tDATE '�'„�j,t' PERMIT
LOCATION - r��v e ti a t ',C j I . ...- N9 1897
n of S-V f ,:.-1- YV%i t t.S S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME tj 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 ❑ Three Bedroom House 900 Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑ 1�--�.
IMPROVEMENTS PERMIT BY .� ."�� /\- ,: /'� INSTALLED BY
CERTIFICATE OF COMPLETION By Date
(8/16/73) *Construction must omply with all other applicable State and local reg lations
LOT AREA IlR
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