972 Greenhill Rd DAVIE CPUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System- G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR 11 I f-9 SINP,r DATE l d-N-76 PERMIT
LOCATION a(`f-er.W 1 Roa.Q NU 1176
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME E3 BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
N0. BEDROOMS N0. 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 ❑ NO ❑ w s�4.�tri, ��,� EX�S �r� �ivha.
SITE SUITABLE YES E3 NO [3
SIZE OF TANK' gal. •S 7
NITRIFICATION FIELD boa O sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY a INSTALLED BY '-�)o_,,;c
CERTIFICATE OF COMPLETION By
muscmMo
Date
(8/16/73) *Construction
local regulations
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DAVIE CQUNTY HEALTH DEPARTMENT
•` '�` (Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR . { 1( -�lt r n I DATE Id 71, PERMIT
LOCATION N? 1176 '
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS N0. 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 ❑ NO ❑ 1'\,C v,s S�Ct` x«.; ,r•,� 'no,
SITE SUITABLE YES [3 NO [3
SIZE OF TANK 90 gal. �•St"r• �`'�
NITRIFICATION FIELD (p0 0 sq. ft.
DEPTH OF STONE IN LINES: /�i��►P4e/cr+-'�
WATER SUPPLY Individual Public ❑
IMPROVEMENTS PERMIT BY '.�+Q...111[tr„rIh INSTALLED BY elaAC:
CERTIFICATE OF COMPLETION By ��-�. tr9a
Date-11-'i,'1(0
(8/16/73) *Construction must c mply with all other applicable State and local regulations
LOT AREA
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