113 Norma Lane Lot 15? 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 DATE PERMIT
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LOCATION #\ 4`7 "f'r'?'i f .1 ' r,.r..: �1�6► ��� L� `p N9 / 22
S.R. N0.
SUBDIVISION NAME LOT NO. 1-Sw SECTION OR BLOCK NO.
HOUSE (( MOBILE HOME BUSINESS ❑
NO. BEfiROOMS j NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ['--
AUTO. DISHWASHER YES G3 --'NO ❑
AUTO. WASH. MACHINE YES C—'NO ❑
SITE SUITABLE YES ®— NO ❑
SIZE OF TANK r :fir') gal..' >
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: IndividualPublic ❑
c
IMPROVEMENTS PERMIT BY
CERTIFICATE OF COMPLETION
BY—
(8/16/73) *Construction must
LOT AREA / J 1 y /
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
/2
l
I
800 Gal.
400 Sq. Ft.
800 Gal.
S Ft.
900 Gal.
00 Ga
_600
'1'900 Sq." `t.`
O1000_G
1ZUD'�
INSTALLED BY
Date/ � -..-L.2.
.y with all other applicable State and local regulations
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5
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