1131 Wagner Rd (3)« .. DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article
13C)
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OWNER OR CONTRACTOR ' / .- r �� '4 DATE 0 % ' -"-PERMIT
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376
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LOCATION/'" ty r•.,! ,"
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1 S.R.
NO.
SUBDIVISION NAME LOT NO. SECTION OR
BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
House Trailer y,.80.__GaL.
NO. BEDROOMSk. NO. BATHROOMS
Two Bedroom House 800
Gal) i600
GARBAGE DISPOSAL UNIT YES ❑ NO 0".,
Three Bedroom House 900
Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES ❑ -NO Q�
Four Bedroom House 1000
Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES �,; NO ❑
SITE SUITABLE YES ED' N ❑
SIZE OF TANK P f�l ga1. f
NITRIFICATION FIELD O r sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑10
" %�) ' "`'
_
IMPROVEMENTS PERMIT BY =� = =
INSTALLED BY
CERTIFICATE OF COMPLETION..ByJ
Date / ``� ' Z?..
(8/16/73) *Construction must conaOy with all other applicable State and
local regulations
LOT AREA
0
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