177 Pine Ridge Rd DAVIE COUNTY..HEA
LTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR c, DATE PERMIT
LOCATION sZ t �C N° 57 9
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE . X MOBILE HOME BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS Two Bedroom House 8 e!O
t.
{ GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House 900 Gal. Sq. Ft.
AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 1000 Gal. Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD L nb sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY �_ 'j` �'l -� r INSTALLED BYr d� 5%tom
CERTIFICATE OF COMPLETION
By Date '= '�
(8/16/73) *Construction must o ply with al other applicable State and local regulations
LOT AREA ,
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