165 Papoose Trail i
_.. DAVIE COUNTY.HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal S stem- G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR Q �Q .s DATE /e:;)-,)D.--)4"PERMIT
LOCATION N? 397
/� S.R. NO.
SUBDIVISION NAMES�
jpypj, .m , .'//,S �.,,,LOT NO. . SECTION OR BLOCK NO.
HOUSE W MOBILE HOME BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS _ NO. BATHROOMS Two Bedroom House0 QO. S Ft.
GARBAGE DISPOSAL .UNIT YES ❑ NO '•�''� Three Bedroom House 900 Gal. 900 S . 'Ft
AUTO. DISHWASHER YES, e�,,�,r�..NO [3 Four Bedroom House •1000 Gal: OO t'
Sq. F .
AUTO. WASH. MACHINE YES,. E. NO > ❑
SITE SUITABLE . off YES 6 NO ❑
SIZE OF TANK 0,00ft gal. '
° NITRIFICATION FIELD fir -- ft.
DEPTH OF STONE IN LINES:,. " S t i Sr: � ►n, /� //•��
WATER SUPPLY: Individu�F4i5-44
Public ❑IMPROVEMENTS PERMIT BYINSTALLED BY
4-7CERTIFICATE OF COMPLETION By Date r3
(8/16/73) *Construction must c&oy with all ,20or applicab.1,e ate and local regulations
LOT AREA ......""
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