1347 Davie Academy Rd (2) APIPW
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J DAVIE COUNTY HEALTH DEPARTMENT
' r 1 U $1fSeptic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage^ Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR 1 DATE C;7 j i'' PERMIT
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LOCATION . s...., f �.,+� . v ..:. d«r, r ✓ ,"'ZX,
%.� S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
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HOUSE MOBILE HOME BUSINESS ❑
r' .i :t .7 House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS 1 _� NO. BATHROOMS ;
Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO U Three Bedroom House 900 Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES ❑-..NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES (] i0 ❑ j + r V� l
SITE SUITABLE YES [ ' NO ❑
SIZE OF TANK ,;` , ga1Ajbg..10 �y+
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NITRIFICATION FIELD ~� Z3 .0 sq. ft.
DEPTH OF STONE IN LINES: r.�.0j.
WATER SUPPLY: Individualq Pub ic,, Elo
IMPROVEMENTS PERMIT BY :t f: �': �' �l.tf!;r:'= INSTALLED BY e ✓� '�( , - ✓
CERTIFICATE OF COMPLETION
By— _� _. Date <;2 9;7
(8/16/73) *Construction must compVy with all other applicable State and local regulations
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