1619 Underpass Road Lot 2DAVIE 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 j ` Li t I J' ri• DATE PERMIT
IT
LOCATION �,a �• nr Ar p t3f f+� �' ''► N �„► �J 3�C✓ 9 917
S.R. NO.
SUBDIVISION NAME Isk5 4 Zd c -e- LOT NO. �,. SECTION OR BLOCK NO.
HOUSE [} MOBILE HOME E3 BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
N0. BEDROOMS —3 N0. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑I�0 ®r Three Bedroom House 900 Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES (� NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES G?` -NO ❑
SITE SUITABLE YES FB�NO 1 ❑ !ioe
,.
SIZE OF TANK gal.
NITRIFICATION FIELD eCupV•/sq. ft.f r�
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ®"''"Public ❑
IMPROVEMENTS PERMIT BY nC�, "
��.__ INSTALLED BY
CERTIFICATE OF COMPLETION
(8/16/73)
LOT AREA
By I \ � roc .C..1A, Date 1
*Construction must compty with all other applicable State and local regulations
vii. X A;144 2.
4 7
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