129 Fostall Drive 1 4 - 1
M DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption__Sewage Disposal..,System G.S.
, . �-4 . ...� Cha tfer 130-Article
13C
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OWNER OR CONTRACTOR DATE J PERMIT
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LOCATION t- ��{�. 1 . a � hvJ t--` ltiteA t't t N9 1135
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S . NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE Q MOBILE HOME BUSINESS ❑
/ House Trailer 800 Gal. 400 Sq. Ft.
N0. BFlDR06MS %.I; NO. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO [ice---' Three Bedroom House 900 Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES ❑ NO [9.-o Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES Q1`� ❑ ;�� � Al
SITE SUITABLE YES [3-00N0 ❑
SIZE OF TANK --z' �'; gal.
NITRIFICATION FIELD sq. ft. -
DEPTH OF STONE IN LINES: r'� '
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY ;` ✓' INSTALLED BY
CERTIFICATE OF COMPLETION e f
By Date _
(8/16/73) *Construction must comply with all other applicable State and local regulation's
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