145 Dalton Rd (2)DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of . Completion
(Ground Absorption Sewag�ey Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR y- �f��...cl t /� DATE -.2 f, _ r} =-HERMIT
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N 162
LOCATION
S.R. NO. J {� J°"►47 -
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOMEBUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS N0. BATHROOMS Two Bedroom House 800 Gala 600 Sq. Ft.
GARBAGE DISPOSAL -UNIT YES ❑ NO ❑ - Three Bedroom House00 Gal. f--T6n0. Sq. Ft.
AUTO. DISHWASHER YES NO ❑ Four Bedroom House -1000 Gal. 1200 Sq. Ft.
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 f d.J2s.G INSTALLED BY
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CERTIFICATE OF COMPLETION Dates Z— 2
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(8/16/73) *Construction mus comply with all other applicable State and local regulations
LOT AREA