317 Miller 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 ;t; JY,•.1l r r. DATE .31/,?/77 PERMIT
tt 9tJ r N° 1360
LOCATION #�i'n� h+rttt'_ �.�?r,h �, . Or�,�.• ` 1.: re:,�E ;nr k�• flt,.� �r: ,e..
*64 S.R. NO.
SUBDIVISION NAME LOT NO. 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 ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑ !` '
SIZE OF TANK
0 gal. cfd
NITRIFICATION FIELD j 0 sq. ft.
DEPTH OF STONE IN LINES: j$'r
WATER SUPPLY: Individual,+ ❑ Public ❑
IMPROVEMENTS PERMIT BY t Dnp p��CLr,•.clo INSTALLED BY ,,,�L� �';. ". Ptd«
CERTIFICATE OF COMPLETION By Date ' /l Y7�
H,c n
(8/16/73) *Construction must comply with all other applicable State and local regulations
LOT AREA
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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 ;c y,, 1trN�.1�-e r DATE 3// 7 7 PERMIT
LOCATION i n' - *� �l�rv:.�e �-�'- —"*�`:v�. N? 1360
11-\J- 1w.; e- S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK N0.
HOUSE PP MOBILE HOME E3 BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
N0. BEDROOMS _ N0. 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 97b gal.
NITRIFICATION FIELD boo sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BY qto INSTALLED BY ` _,:. .S,TT: CO
CERTIFICATE OF COMPLETION 'C ,•yam
By Q & Date 3�/X 7
(8/16/73) *Construction must comply with all other applicable State and local regulations
LOT AREA
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