P740 No Creek Rd �y
DAVIE COUNTY 41EAL'>;H DEPARTMENT
(Septic;Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTQg 1" -.5 -t ,1� : e�:' �! ,-s`r .' DATE 41) %+ Fi,.'' PERMIT
LOCATION
740
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
House Trailer 800 Gal. 400 S�Ftt.
N0. BEDROOMS N0. BATHROOMS Two Bedroom House 0 Gal. 600' S Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO Three Bedroom House •900 Gal. 90 Sq.
'AUTO. DISHWASHER YES ❑ NO Four Bedroom House 1.000 Gal' ' 1200 Sq. Ft.
:AUTO. WASH. MACHINE YES 0 NO
SITE SUITABLE YES NO ❑ . `�,7fi if �� k''. /'' `t
SIZE OF TANK (,1. gal.
NITRIFICATION FIELDelpj go sq. ft. / aa, � 1 � � ,a•� �� y ,,<a
DEPTH OF STONE IN LINES
Public ❑WATER SUPPLY: Individual w
IMPROVEMENTS PERMIT BY INSTALLED BY h/�►y�qtI �i ,� 4 C..b
14,
r
CERTIFICATE OF COMPLETION ByDate r� �•�S 7S`
Tom—
(8/16/73) *Construction must co; ith all other applicable State and local regulations
LOT, AREA C.- e.S` '
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