144 Hartford Ln 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 f-n J3 N j P S Vr DATE PERMIT
LOCATION 1\ 1040
' S.R. NO.
SUBDIVISION NAME LOT NO. ' SECTION OR BLOCK NO.
HOUSE Ej- 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 ❑ 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 ❑
SIZE OF TANK gal.
NITRIFICATION FIELD� n sq. ft.
DEPTH OF STONE IN LINES: z!j
WATER SUPPLY: Individual �' Public ❑
IMPROVEMENTS PERMIT BY i ;;� _ �'E , ._-_.'t€ INSTALLED BY
CERTIFICATE OF COMPLETION r
BY Date
(8/16/73) *Construction must comp
hal o her applica le State and local regulati ns
LOT AREA
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