170 Norma Lane Lot 28DAVIE COUNTY HEALTH DEPARTMENT
(SepticTank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal Systeia - G.S. Chapter.130-Article 13C)`.
OWNER OR ICONTRACTORt;i �, r ; r"{ << sH" DATPERMIT.
FIT,
LOCATION ;-�,s'r£+ r,� Mme.: ?�?-' e 1�� ."gyp . N� 993
k t S.R. N0.
..SUBDIVISI,ON NAME 'ILOT NO.+
° Q.
�..SECTION OR BLOCK N0.
HOUSE MOBILE HOME,' BUSINESS
N0. ,BEROOMS NO. BATHROOMS '
GARBAGE DISPOSAL UNIT: YES
AUTO. DISHWASHER YES, ,(21 NO ❑
AUTO. WASH.' MACHINE YES NO
SITE SUITABLE YES I]""�NO ❑ .
SIZE .OF TANK. -. 00 gal.
NITRIFICATION FIELD? sq. ft:
DEPTH, OY STONE IN LINES:
WATER SUPPLY: Individual Public ❑
INPROVEMENTS PERMIT BY . :r,�•
!House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House' 800 Gal. 600 Sq. Ft.
..Three Bedroom House `900 Gal. 900 Sq. Ft.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
j
INSTALLED BY '
';'i •°,
7—
CERTIFICATE
OF CONPLETION
By",;
''
Date %3� `- �. •'� (.
(8/,16/7:3)
*Construction,mus-c
ply wth.all other
applicable.S,tate.and local regulations
LOT AREA
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