523 Ralph Ratledge Rd (2)DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
y _ T
!r (Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR DATE - : ;'C ` "?� PERMIT
9;
LOCATION i ,c r t , o t ..(i m. I _T
1,...-I�c^, I t. J...-; S?.f --i .ti ilk .., - `Ire.,.. (i 1,. .!t q S. R. NO. 1.31
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE
HOME 0 BUSINESS
NO. BEDROOMS _L� NO. BATHROOMS
GARBAGE DISPOSAL UNIT
YES
❑
NO
❑
AUTO.
DISHWASHER
YES
CR-
NO
❑
AUTO.
WASH. MACHINE
YES
0'
NO
❑
SITE
SUITABLE
YES
❑
NO
❑
SIZE
OF TANK 1t! r0
gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual EY Public ❑
IMPROVEMENTS PERMIT BY
1169
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 TAttj W, Ila nj j I Y M 6;111 <-"O
CERTIFICATE OF COMPLETION Bye
Date �O'
(8/16/73) *Construction must c ply with all other applicable State and local regulations
LOT AREAL`