P1400 Joe Rd 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,i �, ��r � DATE /7't PERMIT
LOCATION ;: ;t. +, . G ,,;" t r :,c.. �'; _ .r �;�_ N° 1400
��'ix. :• F S.R. NO.
SUBDIVISION NAME LO N0. SECTION OR BLOCK NO. -
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 !2t Four Bedroom House 1000 Gala 1200 Sq. Ft.
AUTO. WASH. MACHINE YES NO ❑ .'gq•bu--„ Ou.t.Osd2. 6 2 - 77
SITE SUITABLE YES EI NO [] l �tn,+�- 4'tul� �►'
SIZE OF TANK 1Na gal.
NITRIFICATION FIELD tri sq. ft. �
tea.
DEPTH OF STONE IN LINES: ' + •t'h �+
WATER SUPPLY: Individual , Public �s
IMPROVEMENTS PERMIT BY ,• l"' :��. -,��� INSTALLED BY .
CERTIFICATE OF COMPLETION By bated
(8/16/73) *Construction must c p y with all other applicable State and local regulations
LOT AREA � : + a�_z, r ��x °+� s�/� L
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