P1310 Fox MeadowDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR 5r
At Ca —ret- DATE V2,P,177 PERMIT.
LOCATION
SUBDIVISION NAME I' --v ,i%_aa4W LOT NO.
HOUSE
BUSINESS
NITRIFICATION FIELD 44.5-0 sq. ft.
DEPTH OF STONE IN LINES: _200" levan
WATER SUPPLY: Individual 20 Public ❑
IMPROVEMENTS PERMIT BY
N°
S. R. NO.
SECTION OR BLOCK NO.
House Trailer
800
Gal.
400
Sq.
NO. BEDROOMS 3
NO.
BATHROOMS
Gal.
GARBAGE DISPOSAL UNIT
YES
❑
NO
❑
AUTO. DISHWASHER
YES
❑
NO
❑
AUTO. WASH. MACHINE
YES
❑
NO
❑
SITE SUITABLE
YES
❑
NO
❑
SIZE OF TANK �� gal.
NITRIFICATION FIELD 44.5-0 sq. ft.
DEPTH OF STONE IN LINES: _200" levan
WATER SUPPLY: Individual 20 Public ❑
IMPROVEMENTS PERMIT BY
N°
S. R. NO.
SECTION OR BLOCK NO.
House Trailer
800
Gal.
400
Sq.
Ft.
Two Bedroom House
800
Gal.
600
Sq.
Ft.
Three Bedroom House
900
Gal.
900
Sq.
Ft.
Four Bedroom House
1000
Gal.
1200
Sq.
Ft.
old ppe-,4 vo:aleo/.
INSTALLED BYL� �d
CERTIFICATE OF COMPLETION By %O -e- Date Date Y2S-,177
(8/16/73) *Construction must cc9aply with all other applicable State and local regulations
LOT AREA
cL
It l
j1 J3 b 1
DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR :5A, DATE PERMIT
LOCATION%{� %1}!dA 1� % N� 1310
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
BUSINESS
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE r. YES [3 NO [3SIZE OF TANK ��?o gaol.
NITRIFICATION FIELD "� sq.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public
IMPROVEMENTS PERMIT BY 04.i &
CERTIFICATE OF COMPLETION i
By
(8/16/73) *Construction must c
LOT AREA
ft.
0
House Trailer
800
Gal.
400
Sq.
Ft.
Two Bedroom House
800
Gal.
600
Sq.
Ft.
Three Bedroom House
900
Gal.
900
Sq.
Ft.
Four Bedroom House
1000
Gal.
1200
Sq.
Ft.
INSTALLED BY S--.7: ed
t- ftv.A%dlb Date 1%if 77
ly with all other applicable State and local regulations
j�D �3