208 Ledford Trail A-
DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Abso t on Sewagee� i�spbsalr System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR{ "'F-'' f- � "�-- DATE 1' '- ` PERMIT
69 1403
LOCATION
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOMEBUSINESS ❑
7 1House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS "�_? •— NO. BATHROOMS `,. Two Bedroom House 0 a t.
GARBAGE DISPOSAL UNIT YES ❑ NO L"s Three Bedroom House 1..�QQ . Ft
AUTO. DISHWASHER YES ❑ NO �� Four Bedroom House �tOO�Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES � ❑ )
SITE SUITABLE YES NO ❑
SIZE OF TANK c'�. gal.
NITRIFICATION FIELDsq. ft.
DEPTH OF STONE IN LINES: rJr_ rr
WATER SUPPLY: Individual �f Pub ,c ❑
IMPROVEMENTS PERMIT BY / �� / d' �`� NSTALLED BYti_ S
CERTIFICATE OF COMPLETION
BY .^^�� Date��2�-��9
(8/16/73) *Construction must com y with all other applicable Stat and local regulations
LOT AREA
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