387 Gladstone Rd (2)DAVIE COUNTY HCAYTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorpt.�on Sevjagte Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR !'�:w. �E«r� /`, ! °:+ (r DATE PERMIT
LOCATION ; -� S j `c ,; q ;l j s ,
N° 40
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR
BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
rr
NO. BEDROOMS ,� NO. BATHROOMS �::�"
House Trailer 800
Gal.
400 Sq.
Ft.
.
Two Bedroom House
(z.00
Ft.
"'
GARBAGE DISPOSAL UNIT YES ❑ NO ❑ _
X80"
Three Bedroom House 0
._._
GalA
_...
rt90 S l
4_r
Ft.
AUTO. DISHWASHER YES.❑ NO ❑'-
Four Bedroom House 1000
Gal.
1200 Sq.
Ft.
AUTO. WASH. MACHINE YES NO ❑
t_7
SITE SUITABLE YES NO ❑
SIZE OF TANK `2.5 gal.
NITRIFICATION. FIELD ,'7 !1 t'7 sq. ft.
DEPTH OF STONE IN LINES:.'-�
WATER SUPPLY: Individual Public ❑
'= "'- "_'.'''l
IMPROVEMENTS PERMIT BY r^.'<
INSTALLED BY
CERTIFICATE OF COMPLETION
By �, _ �/
Date
(8/16/73) *Construction must comp with all other applicable State and
local
regulations
LOT AREA C;,r� �y C'•
s