191 Norma Lane Lot 22`^ ti DAVIE COUNTY HEALTH DEPARTMENT
( Septic Tank) ;Improvements. Permit and Certificate of Completion
(Ground Absorpti' sewage D sposal.System - G.S. Chapter 130 -Artie 13C)
OWNER OR CONTRACTOR `! f + „o �. ' DATE-- >
�: j . PERMIT
.. , . N° :'. 816
LOCATION'
4 S.R. NO.
SUBDIVISION NAME 0b) 3lc�fll 1 LOT NO. �� SECTION' OR 'BLOCK .NO.
NO.'BED&OMS_ NO. .BATHROOMS
GARBAGE DISPOSAL UNIT YES NO
AUTO. DISHWASHER YES Moo'. NO ❑
AUTO: WASH. MACHINE YES Cil``'• NO ❑
SITE SUITABLE YES [ ,.• NO. ❑ .
SIZE OF TANK gal.
NITRIFICATION FIELD sq.
DEPTH.OF STONE IN LINES;
WATER SUPPLY: Individual ,, Public ❑
IMPROVEMENTS PERMIT BY
House .Trailer 800`Gal. 400 Sq.
Ft.
Two Bedroom:House 800"Gal. 600 Sq.
Ft.
Three Bedroom House900 Gala 900 Sq.
Ft.
Four Bedroom House, 1000,'Gal., 1200 Sq.
Ft..
u '/z
. �.� t
INSTALLED
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