P108 Riverdale Rd DAVIE COUNTY'HEALTH DEPARTMENT
(Septic Tank) Improvements.Perriit and Certificate of Completion
(Ground Absorption Sewage Disp2w0.Sy.r.Xem,.G-S. Chapter-430-Article 13C)
OWNER OR CONTRACTOR 3 is t' _ E{� DATE 9- 7 VPERMIT .
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.. ._. �.. � N? 108
LOCATION.'_. ',li C CA",I f,.. l�v e�re'c�l
.�zsJVi Aq /'S Gyi4: gA7" S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MI MOBILE HOME BUSINESS ❑ 1
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS Two Bedroom House al.
GARBAGE DISPOSAL UNIT YES ❑' NO f`_ Three Bedroom House. .. �Q, ..s ,>. .
AUTO. DISHWASHER -YES- ❑ NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES. NO ❑
SITE SUITABLE YES NO ❑
_SIZE OF TANK gal,
NITRIFICATION FIELD :" sq.
DEPTH OF'. STONE 'IN `LINES:''. °'
WATER SUPPLY: Individual Public ❑ ,
IMPROVEMENTS: PERMIT BY eer, INSTALLED BY
CERTIFICATE OF,COMPLETION ey e,, Dat
ste�C
(8/16/73) *Construction muomply with all other applicable State and local regulations
LOT AREA
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