249 Dulin 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 _` ��1 ; i N? 445
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME E3 BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS . Two Bedroom House 800 Gal. 600 .Sq. _,Ft.
GARBAGE DISPOSALUNITYES ❑ NO 0-' Three Bedroom House ,00 Gal`
AUTO. DISHWASHER YES 0 NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑ Y.. 3 ,.,ta.. y/�, _ L"6 .,: ref
SITE SUITABLE YES ❑ NO ❑ 0/c: �`d+� '
SIZE OF TANK i,✓ gal.
NITRIFICATION FIELD sq. ft. t, tt , ,� •1a. ', fi �+ ' 5,,'' "
DEPTH OF STONE IN LINES: G c.;,,•'t<.rte.
WATER SUPPLY: Individual 0 Public ❑
IMPROVEMENTS PERMIT BY INSTALLED BY
CERTIFICATE OF COMPLETION Y �, � � Date
B -- -
(8/16/73) *Construction must co ply with all other applicable State and local regulations
LOT AREA
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DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130-AIticle 13C)
OWNER OR CONTRACTOR ',l i g ey%rjti;CKs DATE - a 8'7 PERMIT
LOCATION 1 T N° 445
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE X MOBILE HOME BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
N0. BEDROOMS _ N0. BATHROOMS �_ Two Bedroom House 80 al. 600 t.
GARBAGE DISPOSAL UNIT YES ❑ NO 0' Three Bedroom House 00 Ga 900 S . F
AUTO. DISHWASHER YES (E' NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES Er NO ❑ ✓ „/a . I SZ6 — ✓G 'd e4l
SITE SUITABLE YES [3 NO ❑ D /fie R/',
SIZE OF TANK 9(Sa gal. o-e—
NITRIFICATION FIELD �4D sq. ft.
DEPTH OF STONE IN LINES: —
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY INSTALLED BY
CERTIFICATE OF COMPLETION By Date
(8/16/73) *Construction must com ly with all other applicable State and local regulations
LOT AREA
Pleo
G
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