P1314 Mr Henry Rd'
800
DAVIE COUNTY HEALTH DEPARTMENT
400
Sq.
(Septic Tank) Improvements Permit and Certificate of Completion
Two Bedroom House
800
(Ground Absorption
Sewage Disposal System - G.S. Chapter 130 -Article
13C)
OWNER OR CONTRACTOR �,A-)
DATE 1 /-//77
PERMIT
LOCATION 11AS, c
t
N?
O
roe --�, L-qo
S. R.
NO.
SUBDIVISION NAME
LOT NO. SECTION OR BLOCK NO.
HOUSE ® MOBILE HOME ❑ BUSINESS ❑
NO. BEDROOMS 3 NO. BATHROOMS I
GARBAGE DISPOSAL UNIT YES ❑ NO Er
AUTO. DISHWASHER YES ® NO ❑
AUTO. WASH. MACHINE YES CLI NO ❑
SITE SUITABLE YES ET NO ❑
SIZE OF TANK 0 gal.
NITRIFICATION FIELD/„ sq. ft.
DEPTH OF STONE IN LINES: dIllevel &XAM? 41"L -
WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BY �-t_ N"'+Ct,,J.
1314
House Trailer
800
Gal.
400
Sq.
Ft.
Two Bedroom House
800
Gal.
600
Sq.
Ft.
Three Bedroom House
900
Gal.
900
Sq.
Ft.
Four Bedroom House
1000
Gal.
1200
Sq.
Ft.
INSTALLED BY +%"+e'lt.rL'. Er4 �?H/j/, ecll
CERTIFICATE OF COMPLETION By��Date
(8/16/73) *Construction must ply with all other applicable State and local regul tions
LOT AREA `I V -/ ,/
11:Nol:�(4c-