228 Milling Rd DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorptjon Sewage Disposal System - G.S. Chapter ;130-Article 13C)
•;OWNER OR CONTRACTOR :¢r`.r b •'f3 .�:.rE .,• DATE !�,/ PERMIT
LOCATION , r i, ;-i..ti� ,� °T.t ,; % �.L `'r'!�.r:Cf 7 G N9 1809
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
'"—" HOUSE ❑ MOBILE HOME t3 BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
N0. 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 ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal. ,r
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BY J 1��.rr X16/ INSTALLED BY �
CERTIFICATE OF COMPLETIONTTT
BY C Date
(8/16/73) *Construction must comply with all other applicable State and local regulations
LOT AREA
y%r
-4- �.
4