184 Norma Lane Lot 27615, (Sept
1 .
Z (GrounV Absorp.
OWNER OR CONTRACTOR
LOCATION
SUBDIVISION NAME
;DAVIE COUNTY HEALTH DEPARTMENT
Tank) Improvements Permit and Certificate of Completion
on;;Sewage Disposal System.- G.S. Chapter 130 -Article 13C)
DATE �� ,
: � ''� ,+ PERMIT
N. 1207
r G S.R. NO.
,�
arm �Z t LOT N0. �,, SECTION OR BLOCK NO.
nuubr, A4, PivatLL rium b U MbINE55 U
NO.'- BE _ OOMS N0. ' BATHROOMS
ti !i
GARBAGE DISPOSAL UNIT YES W N0- ❑
AUTO. DISHWASHER fl YES Qcs'' NO ❑
AUTO. WASH. MACHINE". �� YES (°�,NO [3SITE SUITABLE YES ❑NO ❑,
SIZE OF TANK I' gal.
NITRIFICATION FIELD0 ' sq. ft.
DEPTH OF STONE IN LINES�0
�; f1
WATER SUPPLY: Individual ' Public ❑
IMPROVEMENTS PERMIT'! BY
�,
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.
D: & MIA -AAA • ,n�D► a u�v►��.�9
l.,P. � �• $/ 7/71 e&
INSTALLED BY