119 Elk Ln 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 DATE '?-- _, . '! PERMIT 868 p
LOCATION '; s I i,q t' t r' i t 4 N9 8 6 8
1. S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME tj BUSINESS 00
House Trailer 800 Gal. 400 Sq. Ft.
N0. BEDROOMS N0. BATHROOMS 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 ❑
SIZE OF TANK '701) gal.
NITRIFICATION FIELD =��_ r sq. ft. je-rt1 Rock-) koQ Sook
DEPTH OF STONE IN LINES: '
WATER SUPPLY: Individual ❑ Public [0
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IMPROVEMENTS PERMIT BY i 1 s INSTALLED BY
CERTIFICATE OF COMPLETION BY a— Date 2'a717 G
(8/16/73) *Construction must mply with all other applicable State and local regulations
LOT AREA r