1806 Yadkin Valley RdAF 'HEAL7H
DAVIE COUNTY DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR;?:� r "�::t �% " .� ; / �' DATE b — -� PERMIT
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239
LOCATION` .�' It f = 5. %
i S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE,.,% MOBILE HOME t3 BUSINESS ❑
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House Trailer 800 Gal. 400
Sq. Ft.
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NO. BEDROOMS NO. BATHROOMS
Two Bedroom House �/f(lG.a1.
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Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO
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Three Bedroom House X90#0,,) fwd _DQgat
AUTO. DISHWASHER YES ❑ J,NO Q^''
Four Bedroom House 1000 Gal., 1200
Sq. Ft.
AUTO. WASH. MACHINE YES NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANKJ dC� gal.,
NITRIFICATION FIELD, - sq. t.
DEPTH OF STONE IN LINES.
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY •moi~ ' 'vG�''.'t�
INSTALLED BY
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CERTIFICATE OF COMPLETION BV l 7f ?.•C'.�t•. Date
(8/16/73) *Construction must Alcom y with all other applicable State and local regu
LOT AREA
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