162 Red Cedar Way • a DAVIE COUNTY HEALTH bEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR' �,,- ?` DATE ,/* PERMIT
LOCATION N 746
fr M Via—+� ,s,•' -- � v. , _ ✓
S.R. N0.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME BUSINESS ❑
r� House Trailer 800 Gal. 400 Sq. Ft.
N0. BEDROOMS J, ' NO. BATHROOMS Two Bedroom House 800 Gal. 600 S . Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ❑ 4
Three Bedroom House '9"�0 G} 000
AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 1000 Gal. 120q "t.
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE 9 YES ❑ ❑ �� -� "'"�'
SIZE OF TANK 0 d gal. U "� r--- t}�"�- f'' r ', ,-,
NITRIFICATION FIELD %1CJ sq. ft.
DEPTH OF STONE IN. LINES: r2
WATER SUPPLY: Individual Public ❑ '
IMPROVEMENTS PERMIT BY1 �"`y n.:: INSTALLED BY
CERTIFICATE OF COMPLETION '`
By �; /i.% �f._aj-x'• Uti. Date `'�`ily�`.c'
(8/16/73) *Construction must col ply with all other applicable State and local c'gulations
LOT AREA
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