P728 Rainbow Rd DAVIE COUNTY HEALTHtI?EPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absor tion Sewa Disposal System - G.S. Chapter. 130-Arti�Ie 13C) vvv
OWNER OR CONTRACTOR un,,j .. Ian, DATE PERMIT
LOCATION
N° 728
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
N0. BED ODMS .3 NO. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House 90 Ga 900 Sq. Ft.
AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO Q
SIZE OF TANK 1> gal. �� &0,�V
NITRIFICATION FIELD D D sq. ft.
DEPTH OF STONE IN LINES: /�r
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY INSTALLED BYT
CERTIFICATE OF COMPLETION By Date
(8/16/73) *Construction must com with all other applicable State and local regulations
LOT AREA
,�r LSC 3
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