217 Cedar Forest Ln Lot 34 C
L - 3 Iv
r
,. 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 DATE PERMIT
LOCATION t i �- N9 10 9 8
S.R. NO.
SUBDIVISION NAME �f �1-� r �`^�'u< <' ';'i+�'= LOT NO. SECTION OR BLOCK NO.
HOUSE [l MOBILE HOME E3 BUSINESS ❑ :
-vrHouse Trailer 800 Gal. 400 Sq. Ft.
N0. BEDROOMS NO. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ®" Three Bedroom House 900 Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES d NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ _ NO ❑
SITE SUITABLE YES j NO ❑
SIZE OF TANK 'f L','0
gal.
.NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
' WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY INSTALLED BY
r
CERTIFICATE OF COMPLETION By �� Date
(8/16/73) *Construction'must
omply with all other applicable State and local regulations
LOT AREA '. C ; t
M Pt55 CI
. Maw
. k