2385 Davie Academy Rd (2) 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 !tilri i���., !1"� ►a��r,nr_k�_. DATE :'j��j ` PERMIT
LOCATION "L!!'1'.!,c— {,I . i �.t f` , t 1 > r t� .a.'t c, r . 1346
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
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House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS rZ 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 ❑ NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑ -. ��_ ,i,y r,+. 's •1 j� i
SIZE OF TANK ` - � gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual [ Public ❑
IMPROVEMENTS PERMIT BY ',.; I.
-, INSTALLED BY YX.�a $
CERTIFICATE .OF COMPLETION By QK)-t ry\rLMrl Date 3;�,r/77
(8/16/73) *Construction must mply with all other applicable State and local regulations
LOT AREA
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