191 Twin Cedars Golf Rd lnal/.J
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DAVIE COUNTY HEALTH DEPARTMENT Btir tc'a ��
(Septic Tank) Improvements Permit and,Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR •� +�r DATE /, : PERMIT
LOCATION ry / T U r 6 5
-- �^ /�/'S 11x7sfd tr / ..T � .� �'",h?,-7t /. ,�1I ".?SJ�rC N �' V
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 S Ft..
GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House 4 - Ga SOQ'-q F
C..-
AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 0 120Vq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES [3 NO [3 l�
SIZE OF TANK gal.
NITRIFICATION FIELD 60.0 sq. ft.
DEPTH OF STONE IN LINES: /Qp
WATER SUPPLY: Individual . Public ❑
IMPROVEMENTS PERMIT BY ,4 t^ 1Tt, INSTALLED BY ����i t- •?• �UMl3�
CERTIFICATE OF COMPLETION
gy � Date leds".�"
(8/16/73) *Construction must cailnply with all other applicable State and local regulations
LOT AREA
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