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521 NC Hwy 801 N Lot 3-4DAVIE COUNTY HEALTH DEPARTMENT (Septic Tank) Improvements Permit and Certificate of Completion . (Ground Absor on Sewage Diaposal System - G.S. Chapter 130 -Article 13C) OWNER OR CONTRACTOR' i.Tt1 ! iJi £ r DATE c - �} 4—PERMIT 1� . 53 LOCATION S.R. NO. SUBDIVISION NAMEI )D Jf P bnS LOT NO. SECTION OR BLOCK NO. -Z- HOUSE HOUSE MOBILE HOME BUSINESS ❑ If I N0. BATHROOMS House Trailer 800 Gal. 400 Sq. Ft. ```800 NO. BEDROOMS —.It— Tw-edroom House Gal. 600 Sq. Ft. GARBAGE DISPOSAL URIT' YES 0 - NO f_. y4e Bedroom House AUTO. -DISHWASHER, YES ©. O ' ❑ our Bedroom House. 00 Gal. 00 S Ft . AUTO. 1 WASH. MACHINE YES E•NO [3SITE 5, N 0 ❑ SUITABLE YES — SIZE OF .TANK /41212r. gal.' - lJs�,••+ NITRIFICATION FIELD sq. ft. DEPTH OF STORE IN LINES:' WATER SUPRLY:_ Individual) Public ❑ _ ' 0 IMPROVEMENTS PERMIT BY INSTALLED BY �/ ' f CERTIFICATE OF COMPLETIONBy , + / 41 A a y1 Date (8/16/73) ..*Construction must compff with all other applicable State and local regulations LOT AREA . 7__ S 11,