515 Boxwood Church 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 C DATE PERMIT
N9 893
LOCATION
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS ::) NO. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES El NO 9? 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 ❑
SIZE OF TANK ?0-el gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public [3
IMPROVEMENTS PERMIT BY INSTALLED BY
CERTIFICATE OF COMPLETION By Date 74--
(8/16/73) *Construction must P
mply with all other applicable State and local regulations
LOT AREAW 2a(f) C/ a
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