203 or 237 Gun Club Rd (2) DAVIE COUNTY HEALTH DEPARTMENT -
.�! (Septic Tank) Improvements Permit and Certificate of Completion_ ._. __ S�a_49
(Ground .Absorpt n Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR C CTOR 'I? M k-•f DATE PERMIT
N° 73
LOCATIO Cl"'1
S.R. NO. /Gae'76_�
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSEMOBILE HOME BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS Two Bedroom House 8_01. Gal. 60Q Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ❑ hree Bedroo House 900 al. 900q. Ft.
AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ . NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD (?a sq. ft. r
DEPTH OF STONE IN LINES: /o
WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BYr;�� -=s:. r"--. INSTALLED BY
CERTIFICATE OF COMPLETION
BY Date,3
(8/16/73) *Construction must co y with aft other app cable State and. local regulations
LOT AREA
00
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