229 Hepler Rd 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( 7 F,.', ` " : is DATE ;%' �;' PERMIT
LOCATION 1404
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
i
HOUSE ❑ MOBILE HOMEEr BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
N0. BEDROOMS
NO: BATHROOMS Two Bedroom House 800'G41. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ,❑ Three Bedroom House 906�GaIJ 900 Sq. Ft.
AUTO. DISHWASHER YES r-1NO ,Q Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑ / j rj
SITE SUITABLE YES ¢❑ NO y it ' 1 `� c3.. -`ZV
SIZE OF TANK J 0 gal.
NITRIFICATION FIELD z/271') sq. ft. % `, c :u ?+.�. :i� % ✓ , ! /"";'
DEPTH OF STONE IN LINES: i �
;r
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY '�,. i :. +- 4�'r-f���. -INSTALLED BYn, �-
CERTIFICATE OF COMPLETION BY VYVo Date
(8/16/73) *Construction must com ly with all other applicable State and local regulations
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LOT AREA C y-CtL4-c' r`''�_ ff � �� rL7�17 �' 7--"- �6i ,'�✓<. .
16-6 X� ,x 3`A,-t 6,0-,
DAVIE COUNTY HEALTH DEPT.
r
PERK TEST RECORDS
DATE
NAME
LOCATION
COMIMENTS
FINDI14GS: HOLE NO. 1
HOLE N0.2 '
HOLE NO. 3
BY
LOT DIAGRAM
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