141 Vanzant Rd DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sew a Disposal System - G.S. Chapter 130-Article 13C),�
OWNER OR CONTRACTOR DATE l�PERMIT p
LOCATION >✓ - :, 9 O 1 U
r S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME U3 BUSINESS ❑
/ i House Trailer 800:-Gal. 400 Sq. Ft.
NO. BEDROOMS NO. �BATHROOMS
Two Bedroom House F: 800'Gal Ft.
'-*`GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House 900 Gal. 900 'Sq:"Ft:
AUTO. DISHWASHER YES ❑ NO ❑f,,. Four Bedroom douse 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑" NO ❑ ' f , y'
SIZE OF TANK /040 gal.� u
NITRIFICATION FIELD sq.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BY INSTALLED BY
CERTIFICATE OF COMPLETION"' BY - Date
(8/16/73) *Construction must coiapffwitlrall other applicable State and local regulations
LOT AREA
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