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194 Plowman Ln (2) DAVIE COUNTY HEALTH DEPARTMENT (Septic Tank) Improvements Permit and Certificate of Completion (Ground Absorpt on Sewage Disposal System - G.S. Chapter 130-Article 13C) OWNER OR CONTRACTOR s''1 DATE PERMIT LOCATION _ ' '�,y cAu) Z� m N? 1412 S.R. NO. SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO. HOUSE MOBILE HOME BUSINESS ❑ House Trailer 800 Gal. 400 Sq. Ft. N0. B ROOMS N0. BATHROOMS i Two Bedroom House 800 Gal. 600 Sq. Ft. GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House 900 Gal. 900 S . Ft. AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft AUTO. WASH. MACHINE YES ❑ NO ❑ ;� / SITE SUITABLE YES ❑ NO ❑ �'�-'I`"�Y�C �Y J1�c< SIZE OF TANK / tic gal. lj :,5� NITRIFICATION FIELD sq. ft. ;�� DEPTH OF STONE IN LINES: WATER SUPPLY: Individual Public ❑ IMPROVEMENTS PERMIT BY STALLED BY 1 i A CERTIFICATE OF COMPLETION m �a Date (8/16/73) *Construction must comply with all other applicable State and local regulations LOT AREA -•- .�.,.........� _.......M...............,.,,,,d, 12- 1