1587 Underpass Road Lot 6DAVIE 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 DATE fr' PERMIT
LOCATION ^�� � : ^`i
N° 1007
S.R. NO.
SUBDIVISION NAME '� :?C { �:, E=_. LOT NO. SECTION OR BLOCK NO.
HOUSE
HOME El BUSINESS
-a House Trailer
NO. BEDROOMS 3 NO. BATHROOMS Two Bedroom House
GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House
AUTO. DISHWASHER YES Qr NO ❑ Four Bedroom House
AUTO. WASH. MACHINE YES O` NO O
SITE SUITABLE YES M,"' NO ❑ ? ,
gal. -:%� ��
SIZE OF TANK
NITRIFICATION FIELDS' `S` sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑;`
IMPROVEMENTS PERMIT BY �,';.t ,'�'•iir.;;�`y INSTALLED BY HCl<�, 0-A
800
Gal.
400
Sq.
Ft.
800
Gal.
600
Sq.
Ft.
900
Gal.
900
Sq.
Ft.
1000
Gal.
1200
Sq.
Ft.
CERTIFICATE OF COMPLETION '
By
(8/16/73) *Construction must comply
LOT AREA
s'•
Date'-
th all other applicable State and local regulations
• � fi i i i
y