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P1832 Twin Cedars Golf 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 rr '` t ? DATE _F;r,a f PERMIT LOCATION 1832 r ' S.R. NO. SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO. HOUSE ❑. MOBILE HOME RZ BUSINESS ❑ N0. BEDROOMS N0. BATHROOMS House Trailer 800 Gal. 400 Sq. Ft. 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 ❑ 1' SIZE OF'TANK gal. r ; NITRIFICATION FIELD sq. ft. i DEPTH OF STONE IN LINES: � l `-' �/, .tY WATER SUPPLY: Individual ❑' Public ❑ IMPROVEMENTS PERMIT BY /�-; : .ar:', INSTALLED BY CERTIFICATE OF COMPLETION By Date `S 2S 1 (8/16/73) *Construction must comply with a other applicable State and local egulations LOT AREA - f ' �,,,✓ '..�'..-i^G.F-.Y.rl.�' .t!/.-'L rr?r,v^"YLsT i t 1 DAVIE COUNTY HEALTH DEPARTMENT P. 0. BOX 57 MOCKSVILLE, N. C. 27028 (704) 634-5985 Statement for Septic Tank Improvement Permits and/or Site Evaluations NAME 7��-�u� G �72QhQ—� DATE ISSUED ' 5�7� ADDRESS . PERMIT NO. Ar � Explanation of char e - r � AMOUNT DUE,` • SANITARIAN / PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEMENT.