P510 Riverview Rd DAVIE COUNTY HEALTH DEPARTMENT
(Septic .Tank) Improvements Permit and Certificate_of.Completion
(Ground Abso ption .S . age'Disposal System =` G.S.'Chapter 130-Article 13.x)
— PERMIT
LOCATION .
DATE
OWNER OR CONTRACTOR Hi.i S'- f JC .-j" - _'"_-
LOCATION . rn..r,.' t�^ I !�,,. , c i?. N? 510
z' S.R. NO.
SUBDIVISION i�ME LOT NO. SECTION OR BLOCK NO.
HOUSE ® MOBILE HOME E3 BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft..
NO. BEDROOMS NO. BATHROOMS Two Bedroom House 800 Gal. 600 'S
GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House .0 Gal. ('900 Sq. Ft.%
AUTO. DISHWASHER YES C3 NO ❑ Four Bedroom House 10W-Gal. -1700'Sq.�Ft.
AUTO. WASH. MAC INE YES ❑ NO ❑
SITE SUITABLE (/(y YES ❑ NO ❑
SIZE OF TANK al.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ;, Public ❑
IMPROVEMENTS PERMIT BY 1'��.'..,:. :�: INSTALLED BY r,', - "t'Y, r�,..'.
CERTIFICATE OF COMPLETION By Date
(8/16/73) *Construction must comply with all other applicable State and lo c ulations
LOT_ AREA ``