1861 Milling Rd t DAVIE COUNTY-HEAi.TH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion 30
_ (Ground Absorption Sewage'Disposal System - G.S. Chapter 130-Article 13C)
1`YOWNER)OR CONTRACTOR : I�Ue _ �-6 rr GS'�" DATE PERMIT
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LOCATION 549
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
NO. BEDROOMS NO. BATHROOMS rt'• House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800'Gal_. 6Da•_S<-., X-t-
GARBAGE DISPOSAL UNIT YES ❑ NO ❑' Three Bedroom House ,-'900 Gal. ' '900 Sq. Ft.�
AUTO. DISHWASHER YES ❑ NO [E' Four Bedroom House �-100b0 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES C3' NO ❑ /�1, �; j -t. ,,:��rt •' � Jots— ' !'C
SITE SUITABLE YES [3 NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BY0,� ix - ,,,j%.j INSTALLED BY ZU� 4 .$•T eo. �C,�
CERTIFICATE OF COMPLETION
BY Date It o� '-"7Sr
(8/16/73) *Construction must c mply with all other applicable State and local regulations
LOT AREA » 7,4,.l /u'r ;: •'u*s+a tl c?a t., coal• j zi
't•'.Y'dam... r�, j F,�^'C.,^-.{d'l f r i! 7 16
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