P991 Indian Hills DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR i, r .;_-., ^,v 6 , 'tr DATE e," . 7�:+. L PERMIT
LOCATION N9 991
S.R. NO.
SUBDIVISION NAME ] .'�',�1 ` ",r'. �.; - LOT NO. SECTION OR BLOCK NO.
r •
HOUSE MOBILE HOME BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEbROOMS � 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. NO ❑ 1 r''% "!�. r �" 'C
SITE SUITABLE YES ❑ NO ❑ d�' r,�t• ; n, 1... r' r , �+A .•r, / {'
SIZE.-QF TANK ?' gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES: ���-4 ''^,`' `�
WATER SUPPLY: Individual Q. Public ❑
IMPROVEMENTS PERMIT BY INSTALLED BY
CERTIFICATE OF'COMPLETION
Date `f, / -)
By -
67-
(8/16/73) *Construction must comp with all other applicable State and local reg at-ions
LOT AREA
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