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115 Danner Rd (3) 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 _A I. f--r�=--a--�4 10 /1 DATE .�' �i- s; PERMIT LOCATION M 963 S.R. NO. /!6e+ ..2_ SUBDIVISION AM LOT NO. SECTION OR BLOCK N0. HOUSE ❑ MOBILE HOME BUSINESS ❑ 17 House`Trailer 800 Gal. 400 S _ Ft. NO. BEDROOMS N0. ODMS Two Bedroom House _47Ga 600 GARBAGE DISPOSAL UNIT YES ❑ NO Three Bedroom House 00 Gala 00 Sq. Ft AUTO.` DISHWASHER YES ❑ NO Four Bedroom House 1.000 Gal. 1200 Sq. Ft. AUTO. WASH. MACHINE YESr NO e SITE SUITABLE YES NO ❑ L,a '�` ' "r f_ j' SIZE OF TANK Uv gal. f _ VQ NITRIFICATION FIELD sq. ft. ` DEPTH OF STONE IN LINES: WATER SUPPLY: Individual Public ❑ IMPROVEMENTS PERMIT BY ��f4..rr{ �� INSTALLED BY CERTIFICATE OF COMPLETION By Date (8/16/73) *Construction must co ly with all other applicable State and local regulations LOT AREA ICA �- �--� 1 III ! IQ i s � i 1 i j / t S l 1 Y • bx/