141 E Renee Drive Lot 24DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion �Q Y'000
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR DATE" - - 7 '4 PERMIT
LOCATION l.% , fi - I - r- I r_` + l 1\ 535
\ 't y' v� z; �f _ f } , t !! ice"` ef.i •.SSC {I'Y� �t'T'• •
S.R. NO.
SUBDIVISION NAME `,,.��a<> r .e r;. LOT NO. SECTION OR BLOCK NO.
HOUSE
BUSINESS
NITRIFICATION FIELD 45"n sq. ft.
DEPTH OF STONE IN LINES: j 'A"dz 10
WATER SUPPLY: Individual Q Public ❑
IMPROVEMENTS PERMIT BY `.•*�" Y`�"'�,' .. ,. ,� �.
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House §DO. -Gal. 60,G-£q,_,F.,t.
Three Bedroom House <' 0 Ga1,�5 00 Sq. Ft.j
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
...`}I { c., Ll=. k.).::'r,..+.� .`.C.. mow' '• ' C.` !
y
INSTALLED BY } i_ `� • f 1 t7 +
CERTIFICATE OF COMPLETION
"C'i �1►[z.,h E� h Date 7- %oS
(8/16/73) *Construction must c6ply with all other applicable state and local regulations
LOT AREA ;'a r- 1 ; ,J ',,,, ), r
f o AAA 4 rii ; n e..
Jot ;s :y4v.4;9�cT ta`ab'+/% H+Pon, �.,..41i
tick a
NO. BEDROOMS
NO.
BATHROOMS
GARBAGE DISPOSAL UNIT
YES
❑
NO
❑
AUTO. DISHWASHER
YES
❑
NO
❑
AUTO. WASH. MACHINE
YES
❑
NO
❑
SITE SUITABLE
YES
❑
NO
❑
SIZE OF TANK q D
gal.
NITRIFICATION FIELD 45"n sq. ft.
DEPTH OF STONE IN LINES: j 'A"dz 10
WATER SUPPLY: Individual Q Public ❑
IMPROVEMENTS PERMIT BY `.•*�" Y`�"'�,' .. ,. ,� �.
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House §DO. -Gal. 60,G-£q,_,F.,t.
Three Bedroom House <' 0 Ga1,�5 00 Sq. Ft.j
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
...`}I { c., Ll=. k.).::'r,..+.� .`.C.. mow' '• ' C.` !
y
INSTALLED BY } i_ `� • f 1 t7 +
CERTIFICATE OF COMPLETION
"C'i �1►[z.,h E� h Date 7- %oS
(8/16/73) *Construction must c6ply with all other applicable state and local regulations
LOT AREA ;'a r- 1 ; ,J ',,,, ), r
f o AAA 4 rii ; n e..
Jot ;s :y4v.4;9�cT ta`ab'+/% H+Pon, �.,..41i
tick a