P153 Deadmon Rd• , t DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate_.of.,Completion
(Ground Absorption Sewag Disposal Systeta , G.S. Chapter 130-Article
13C)
OWNER OR CONTRALTO lh : S t3 t DATES A
PERMIT
N° 153
LOCATION �Ak '
LI S.R.
NO. j s"
SUBDIVAON NAME LOT NO. SECTION OR
BLOCK NO.
HOUSE ❑ MOBILE HOME EJ BUSINESS ❑
1.
NO. BEDROOMS . NO. BATHROOMS
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House-8.0.Q..Ga 40Sq...-.F
GARBAGE DISPOSAL UNIT YES NO ❑"r
Three Bedroom House j_l(1Q.�.a.1..►
I-9Q0_.Sq.�„
AUTO. DISHWASHER YES NO ❑
Four Bedroom House 1000
Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES Ur NO ❑
SITE SUITABLE YES ❑ NO ❑
^�
IV,\
SIZE OF TANK gal •
�
NITRIFICATION FIELD sq. ft.
F!
'''r��
DEPTH OF STONE IN LINES: ! •.
WATER SUPPLY: Individual ON, Public ❑
IMPROVEMENTS PERMIT BY
INSTALLED BY
CERTIFICATE OF COMPLETION �(1���rn�
BY
Date
(8/16/73) *Construction must c mply with all other applicable State and
local regulations
LOT AREA