P1148+ DAVIE COUNTY HEALTH DEPARTMENT
.(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 130)
OWNER OR CONTRACTOR DATE PERMIT
LOCATION 114 8
1° No
yr. S.R. NO.
SUBDIVISION NAME LOT`NO. SECTION OR BLOCK NO.
HOUSE p MOBILE HOME] BUSINESS ❑
NO. BEDROOMS NO. BATHROOMS r
GARBAGE DISPOSAL UNIT YES ❑ NO
AUTO. DISHWASHER YES ❑ -NO
AUTO. WASH. MACHINE YES L:1 ,.NO ❑
SITE SUITABLE YES (� NO ❑
SIZE OF TANK �j .fl D ga 1 •
NITRIFICATION FIELD Alt+, r sq. ft.
DEPTH OF STONE IN LINES: J:�r
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY
House Trailer
Two Bedroom House800
800 Ga,l
a1
400 S
6Ga(01,.S. �,. Ft
Three Bedroom House
�.._. -
900 Gal.
900 Sq.
Ft.
Four Bedroom House
1000 Gal._
1200 Sq.
Ft.
/,3 �,, :5` x 1 cu"
INSTALLED BY
t
CERTIFICATE OF COMPLETION ! -
By Date
(8/16/73) *Construction must compW with all other applicable State and local regulations
LOT AREA QIR,�
i