762 Main Church Rd DAVIE C VJAY HEALTH DEPARTMENT
(Septic Tank) IYn romerrtS .Permit and Certificate of Completion
(Ground Absorp do1 Sewage 14 ' til- System - G.S. Chapte ' 13'p-Article 13C),
OWNER OR CONTRACTOR 1.
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LOCATION �„ i _�'��a t1 '1;,'Q�i ,,.'1C :~► f..,« w40 +� !
- .R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME E3 BUSINESS ❑
House Trailer 800 Gala 400 Sq. Ft.
NO. BEDROOMS N0. BATHROOMS., Two Bedroom House . 800 Gal." 60 F
GARBAGE DISPOSAL UNIT YES ❑ NO [ Three Bedroom House ,9Za cla 900_
AUTO. DISHWASHER YESP NO ❑ Four Bedroom House10001000 Gala Sq. Ft.
AUTO. WASH. MACHINE E . YES NO ❑ -i0 ,�{� """ w,G` 14L> 31 '{U
SITE SUITABLE pp YES ❑ NO ❑ 'k r, ��+ r` 4 �'� `kciC +N
SIZE OF TANK <D gal. t
NITRIFICATION FIELDOsq. ft.
DEPTH OF STONE IN LINES: teve /Faw'T � a*:' �"fi e.. - C'*4 r r .. r•' ' I �r`
WATER SUPPLY: Individual . Public{ ❑
IMPROVEMENTS PERMIT BY S- 1 ' `. w INSTALLED BY ?A,41 W+ 1 1 Q r A'
CERTIFICATE OF COMPLETION By f Date !b011''734
(8/16/73) *Construction must co ply with all other applicable State and local regulations
LOT AREA
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