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193 Oak Tree Drive Lot 52
.I -, ' f a DAVIE COUNTY HEALTH DEPARTMENT '/� 2, 9 � 2 -- r 4Ti, (Septic Tank) Improvements Permit and Certificate of Completion (Ground Absorption Sewage Disposal System,G.S. Chapter 130 -Article 13C) OWNER OR CONTRACTOR r DATEPERMIT 1 p LOCATION N� 18 4 S.R. NO. SUBDIVISION NAME °� '�' i ' »s : , �r= r; 6�` LOT NO. „"'%;a SECTION OR BLOCK NO. HOUSE ^ MOBILE HOME ❑ BUSINESS ❑ NO. BEDROOMS NO. BATHROOMS GARBAGE DISPOSAL UNIT YES ❑ NO 3--- AUTO. 'AUTO. DISHWASHER YES ❑ NO ©''' AUTO. WASH. MACHINE YES ER" NO ❑ SITE SUITABLE YES ©y NO ❑ SIZE OF TANK / drb gal. NITRIFICATION FIELD p O sq. ft. DEPTH OF STONE IN LINES: C7 WATER SUPPLY: Individual Public's IMPROVEMENTS PERMIT BY House Trailer Two Bedroom House Three Bedroom House Four Bedroom House 800 Gal. 400 Sq. Ft. 800 Gal. 600 Sq. Ft. 900 Gal. 900 Sq,Ft, 1000 Gal. Sq. Ft.1 11200 x_2 ch .h INSTALLED BY i dol, z /c� n CERTIFICATE OF COMPLETION By ` Date (8/16/73) *Construction must comply with all other app icable State and local egulations LOT AREA aE17 I Q'C' ..:yo ori