P137 Peoples Creek Rd DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements 1.Permit and Certificate of Completion
(Grourid`Absorption Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR.-CONTRACTOR
DATE - to 7"/ PERMIT
N 137
LOCATION j:t�.. ter } ,.; i - �
S.R. NO. 115,v6
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE I MOBILE HOME E3 BUSINESS ❑ -
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS ` NO. BATHROOMS t,z Two Bedroom House .800 Gal. 600 Sq. Ft..
Three Bedroom House 90�f aa.. 90
GARBAGE DISPOSAL UNIT YES ❑• NO ❑ meq'•
AUTO. DISHWASHER YES ❑� NO ❑ Four Bedroom House 000 Ga 200 Sq. Ft.
AUTO. WASH. MACHINE YES II _ NO [3
SITE SUITABLE YES 0 NO ❑ j�tJ c+ • ..,., ►a r r) C t==.,r� - '.4 c 'R
SIZE OF TANK Iclez: gal. t� .,5�. �{-J r-�: :(' �c � } r �p�,• 1.
NITRIFICATION FIELD sq. ft.
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DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY y INSTALLED BY (7 ; I r
CERTIFICATE OF COMPLETION Date
(8/16/73) *Construction must mply with all other applicable State and local regulations
LOT AREA
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DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR f 3 o h n DATE`- 8 — 7T PERMIT
LOCAT-16N o 5Da
�; i. -oma �t•, l� N° 137
S.R. NO. y� /
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE .HOME BUSINESS ❑
House Trailer 800 Gala 400 Sq. Ft.
NO. BEDROOMS N0. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑� NO ❑ Three Bedroom House 900 . 900
AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 0 Gal2 0 Sq. Ft.
AUTO. WASH. MACHINE YES �1'NO ❑
SITE SUITABLE YES [2'-- NO ❑ /Jo lar"-T Wets' a' ti�er� �tl S-}sTe1^
SIZE OF TANK /4tp[�) gal.
NITRIFICATION FIELD /a o sq. ft.
DEPTH OF STONE IN LINES: G"— /Pr,
WATER SUPPLY: Individual Public ❑ " '
IMPROVEMENTS PERMIT BY —ae4 INSTALLED BY c q c
CERTIFICATE OF COMPLETIONS_g-7y�
BY Date
(8/16/73) *Construction must mply with all other applicable State and local regulations
LOT AREA
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