707 Angell Rd DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion -
(Ground AbsorpE Sewage Disposa'l,System - 'C.S. •Chapter' 130-Article 13C)
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LOCATION ,;i e' + .i., r., 'r;.: ria 1\ .
S.R. NO.
SUBDIVISION NAME - LOT NO. SECTION,OR BLOCK NO.
HOUSE M MOBILE HOME E3 BUSINESS ❑
' House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDI200MS .,_,. NO. BATHROOMS Two Bedroom Houseraw--9-Q'-Ft.,
GARBAGE DISPOSAL UNIT YES El NO ❑ Three Bedroom House UZ� (,,W_. S.q..
AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑l NO ❑
SITE SUITABLE YES . NO ❑
SIZE OF TANK QSO' gal.
NITRIFICATION ,FIELD 9y'D sq. ft.
DEPTH OF STONE IN LINES: (Q w
WATER ,SUPPLY: Individual ] P, Public - ❑
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IMPROVEMENTS PERMIT BY 'a' ` ` ;''" ''' '` '•-. INSTALLED BY L1v
CERTIFICATE OF COMPLETION By p Date /D7�"
(8/16/73) *Construction must co ply with all other.-applicable State and local regulations
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