191 Valley Oaks Drive Lot 13 DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absor tion Sew�Sp Disposal System - G.S. Chapter 130-A ticle 13C)
04iNER (1Bw,CONTRA"TOR N r, l f?011 1S'+! 11 DATE I""f PERMIT
�� ,. ,/ • Ali ,y..,'n�r�r �lr,0A_ N° 1258
LVATION <
S.R. NO.
SUBDIVISION NAMEf i LOT NO. «~ SECTION OR BLOCK NO.
HOUSE MOBILE HOME_Ej BUSINESS ❑
NO. BEDROOMS � NO. BATHROOMS 9X je House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House �6 &Z,.5F5
Ft
GARBAGE DISPOSAL UNIT YES ❑ -NO ®"' Three Bedroom House 7=S!q
AUTO. DISHWASHER YES [ ✓`NO ❑ Four Bedroom House 000il�
l 1200
AUTO. WASH. MACHINE YES L� NO Q 4�r1r -""' V �r Q<.?.
SITE SUITABLE YES NO
SIZE OF TANK , gal. .:�rN 'S 1�( „� � ; / ,•�T.�c.& 4 k-tj v/
NITRIFICATION FIELD /� sq. ft.
DEPTH OF STONE IN LINES: I�� r !. `V
WATER SUPPLY: Individual Public
IMPROVEMENTS PERMIT BY �' w'�+- Y� INSTALLED BY
CERTIFICATE OF COMPLETION By !,: �, _�,/,�� Date
(8/16/73) *Construction must comply with• all � her applicable State and local regulations
LOT AREA
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