P323 Deadmon Rd DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and;Certificate.of:,CoinPI
etion
(Ground Absorption SewagDis�osal System - G.S. Chapter 10-Article 13C)
OWNER OR CONTRACTOR 'rC ;'T ,Pty" DATE " , PERMIT
LOCATION tt ill Fi h tY.i �ffi i` �v, f _ N?. , 323_
S.R. N0. $O
SUBDIVISION NAME LOT. NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME In BUSINESS ❑
P House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS Two Bedroom House 600
GARBAGE DISPOSAL UNIT YES ❑ NO Three Bedroom House 1900 Ga 1900 Sq. Ft.
AUTO. DISHWASHER YES ❑ NO E Four Bedroom House 0-0 7 GaE 1200 Sq. Ft.
'AUTO. WASH.' MACHINE' YES &,No - ❑,_. ,
SITE SUITABLE . YES ❑ NO ❑ J�
SIZE; OF TANK 9993 gal.
NITRIFICATION FIELD ? sq. ft*
DEPTH OF STONE.IN LINES
WATER SUPPLY: Individual' Public ❑
IMPROVEMENTS PERMIT BY t - INSTALLED BY ~-,t-^r
"".
7 G�
CERTIFICATE OF COMPLETION
By; �, - y � Date
:r-
(8/16/73) *Construction must comply with all other applicable State.-and-local-.-regulations
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