1355 Sheffield 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 DATE /" — PERMIT
LOCATION
7GIi t^. f � s . e'_ .''' t ���z, r N° 1127
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME BUSINESS ❑
R%
House Trailer 800 Gal. 400 Sq. Ft.
NO. BF ROO S NO. BATHROOMS Two Bedroom House 600 S Ft.
q•
GARBAGE .DISPOSAL UNIT YES Ele' 900:Gaj
NO ❑ Three Bedroom House r 960 Ft
AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. t.
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑ �� /
SIZE'`OF TANK 9g> 40 gal. *7 F«7la
NITRIFICATION FIELD ` D 'n sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual/ ,Public ❑
IMPROVEMENTS PERMIT BY INSTALLED BY
CERTIFICATE OF COMPLETION By. a Date 42L/0
:. (8/16/73)' *Construction must Yomply with all other applicable State and local regulations
LOT AREA
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3 � 3
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