170 Hill Top Dr (2) DAVIE COUNTY HEALTH DEPARTMENT 1 iiehld ���
(Septic Tank g rove Dents Pernut and Certificate of Completion. .,
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(Ground Abso ion Sewa eyDis al. System G.S. Chapter '130-Article 13C)
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OWNER OR CONTRACTOR 't`s i' tl�j' �)N DATE F PERMIT
CATION b^3, 1 t!0 V L 1 ( C N • 914
�1 11C 4,V4 S.R. N0.
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SUBDIVISION NAME hDALf�f'• GtrV :. ;' �j4,,;,1OT N0. SECTIONbR BLOCK N0.
HOUSE MOBILE HOME BUSINESS ❑
NO. BEDROOMSHouse Trailer 800 Gal. 400 Sq. Ft.
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 M-" "N0 ❑
SITE SUITABLE': YES CP,•�"� ❑ .
SIZE OF"TANKBal•
NITRIFICATION. FIELD � .+' " ` s ., ft.
DEPTH OF.STONE .IN• LINES: ,,� '� �•� P
WATER SUPPLY: Individual EP-"Public EF
IMPROVEMENTS'.PERMIT BY, -INSTALLED BY
CERTIFICATE OF COMPLETION
7 .- BY Date r�` �� � d
x(8/16/73) *Construction must comp th all of er -applicable State and local regulations '
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