116 Brook Hill Court Lot 39DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTORr ,
DATE I .. ""L • W. PERMIT
LOCATION Qv fir„ ,�,,� "l rt. N� 853
S.R. NO.
SUBDIVISION NAME ItJrw�rlLr r,_ LOT NO. SECTION OR BLOCK NO. 3
HOUSE 00 MOBILE HOME 0 BUSINESS
NO. BEDROOMS- E NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO 9•
AUTO. DISHWASHER YES NO ❑
AUTO. WASH. MACHINE YES NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ® Public ❑
IMPROVEMENTS PERMIT BY i yZv.rt(y
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800. Gal. 600 Sq. Ft.
Three Bedroom House~ 9.Q.Q.....Ga1':',1--...900 Sg
Four Bedroom House1000 Gal. 1200 Sq. Ft.
�" I 13
INSTALLED BYJT, �)-
CERTIFICATE OF COMPLETION By �� I ��a�,� Date
(8/16/73) *Construction must Comply with all other applicable State and local regulations
LOT AREA
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