262 Pinebrook School Rd (2) DAVIE COUNTY HEALTH DEPARTMENT
�,.._. (Septic Tank) Improvements-Permit and Certificate of Completion
(Ground Absor�P ion, Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR CON 'f :� DATE PERMIT
LOCATION i M '>7"-3°+r� . "t`I 3'm e t't , :✓�°x°z 1 c• Iry 9`a�> r 'S�u r -, ,/:.,N9 474
4
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
/ House Trailer 800 Gal. Ftp
NO. BEDROOMS t7V N0. BATHROOMS
Two Bedroom House $� Gal 46 Q.R,.
GARBAGE. DISPOSAL UNIT YES ❑ NO Three Bedroom House` 900 Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES Q NO `0 Four Bedroom House 1..000 Gal. 1200 Sq. Ft.
AUTO.' WASH. MACHINE YES ]a NO ❑ y
SITE SUITABLE YES NO ❑ ,.,� ,, d r ., ac:
SIZE_ OF .TANK ga 1.
NITRIFICATION FIELD IoOO sq. ft'.
ii
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual,.- Public ❑
IMPROVEMENTS PERMIT BY
� 1 INSTALLED BY �K)DW
CERTIFICATE OF COMPLETION y( AS
BY f Date
(8/16/73). *Construction must comptf wit `ill other applicable State and local regulations
LOT AREA �, .Qr ; �•
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