P375 Underpass Rd DAVIE COUNTY HEALTH DEPARTMENT
— (Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Dis�pp..sa1System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR ,� � %' � f- �r ; DATE PERMIT
LOCATION
N? 375
t ! w_ -`fi:s1 =;x.' i. .+*,�S.R. NO.
SUBDIVIs N N LOT N0. SECTION OR BLOCK NO.
HOUSE MOBILE HOME El BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS Z,- NO. BATHROOMS
S7� Two Bedroom House 800 Ga . _x.600 'S" F—t.
GARBAGE DISPOSAL UNIT YES ❑ NO Three Bedroom House00 Ga 900 Sq Ft.
AUTO. DISHWASHER YES NO Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES , 1 NO ❑
SITE SUITABLE YES,Zff NO ❑ �/, : ,+�, ��'a U ��! � 7 '
SIZE OF TANKL&J4 ce
NITRIFICATION FIELDsq. ft.
DEPTH OF STONE IN LINES.:.. - s
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY + �--, INSTALLED BY`-4 / c7 c'J�-t
CERTIFICATE OF COMPLETION
By Date "'
(8/16/73) *Construction must co TY with alt other applicable State and local regulations
LOT AREA
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