P1150 Hwy 158DAVIE COUNTY HEALTH DEPARTMENT
4 (Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System
C.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR
DATE
PERMIT
LOCATION ir 1\ 9 1150
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME E3 BUSINESS 0
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROQMS NO. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES El NO 0- Three Bedroom House '900 Gal.I .9-00—S5. Ft.
AUTO. DISHWASHER YES ❑ NO Four Bedroom House 1000 Ga 1. '1200 Sq. Ft:.
AUTO. WASH. MACHINE YES No
SITE SUITABLE YES 0 I O
SIZE OF TANK Z%)n- gal.
NITRIFICATION FIELD Sq. ft.
DEPTH OF STONE IN LINES: �7 �
WATER SUPPLY: Individual— Public
-
IMPROVEMENTS PERMIT BY -INSTALLED BY rZ
CERTIFICATE OF COMPLETION By
Date
(8/16/73) *Construction must comity with all other applicable state and local regulations
LOT AREA