383 Juney Beauchamp Rd DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absor tion Sewage isposal System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR DATE PERMIT
LOCATION j .,�. lr? 82
_r!g � e.0S.R. N0.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME BUSINESS ❑
„7 House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS s.••�" 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 ❑ our e room Ouse 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES NO ❑
SITE SUITABLE :i� YES 09----~NO ❑ r J t �, ,�1
SIZE OF TANK _y ` ' _ gal. r't! , Y T� #?+l: /CC CE '/ t
NITRIFICATION FIELD sq. ft. J�Itr`?C 1.T�f' "!bt` 4
/ r
DEPTH OF STONE IN LINES: Aq n/
WATER SUPPLY: Individual ®''"Public ❑
IMPROVEMENTS PERMIT BY ' ^ - „ <-� �,..• INSTALLED BY .
CERTIFICATE OF COMPLETION By � ,�� Date-53 '`7
(8/16/73) *Construction must mply with all other applicable State and local regulations
LOT AREA
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