140 Allen Rd (2)DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR I)),trk,' (1; �4�.*;, 1; (%,t^C.: DATE �A-�'�-��� PERMIT
LOCATION i..., / tl,, x/ - . �? :.� i , -: �*� ! ,:f N° • 588
SUBDIVISION NAME
S.R. NO. / 3b54
LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME ® BUSINESS
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD d& sq. ft.
DEPTH OF STONE IN LINES: 154t/I
WATER SUPPLY: Individual [ Public ❑
IMPROVEMENTS PERMIT BY:��.�
CERTIFICATE OF COMPLETION
By
(8/16/73) *Construction must comply with al
LOT AREA
House Trailer 800 Gal.
400 Sq. Ft.
Two Bedroom House 80 1.
Three Bedroom House 00
60—Sq,,
SqFt..
`900
Four Bedroom House 1000 Gal.
12ZZ q.
7
etfro - xltz
Ajct
;
INSTALLED BY <J/15 :5e pfse k e
Date 7— 2 — 75
,heft ip#licable State and local regulations
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