1289 Angell Rd N
DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Grouiid'Absorption Sewage Disposal System - G.S. Chapter 130 Article 13C)
OWNER OR CONTRACTOR : F „, DATE S ', 7S'
LOCATION
LOCATION _ `_ o s /'l D" NG E' R J . l�? 610
1)y, i t�N 4�. j*OiA Sfe ' VAJ , -? S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO. i
a
HOUSE ❑- MOBILE HOME BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑.- NO [ Three Bedroom House 900 Gal.. . 900 Sq. Ft.
AUTO. DISHWASHER YES ❑ ' NO Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ® 0 ❑ . vI
SITE SUITABLErte, YES [3NO
SIZE OF TANK 1 gal....._ , L7
NITRIFICATION FIELD sq. ft. .
DEPTH OF STONE IN LINES: '
WATER SUPPLY: Individual ❑`' Public ❑ -
IMPROVEMENTS PERMIT BY ' . „ „„ . INSTALLED BY r1dk ,•,,
CERTIFICATE OF COMPLETION By �/1gMg Date 5
(8/16/73) *Construction must com y with all other applicable State and local regulations
LOT AREA
40
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