203 Woodburn Place Lot 20.2 V -f
DAVI
i COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption 'Sewsa
Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR _ U I (�aC
is" It�PrS DATE PERMIT
LOCATION x(01 �n r w,:,V, `
q q
N? 10 `f 9
S.R. NO.
�.+ ^
SUBDIVISION NAME CAtck. �boe]�
�Stct{cS LOT NO. 2-0 SECTION OR BLOCK NO.
HOUSE MOBILE HOME E3
BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft."
N0. BEDROOMS N0. BATHROOMS
Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑
N0 ❑
Three Bedroom House 900 Gal. 900 Sq: Ft.
AUTO. DISHWASHER YES. ❑
NO ❑
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑
NO ❑
SITE SUITABLE YES ❑
NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD-
sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Q'
Public ❑
IMPROVEMENTS PERMIT BY '
INSTALLED BY
CERTIFICATE OF COMPLETION BY
Date -%b
(8/16/73) *Construction must
omply with all other applicable State and local regulations
LOT AREA
7b LV J_. A'`a-'
.2 V -f
y �
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. ai i::..:!I DATE PERMIT
r 1.
LOCATION <O � t n r .+ 1+ 1, �T
9• .1049
S.R. NO.
SUBDIVISION NAME FSjArS LOT N0. 2D SECTION OR BLOCK NO.
HUubh l-1 XUBILC
HUMS
U
9U51NES5
Sq.
Ft.
Two Bedroom House
800
Gal.
NO. BEDROOMS
NO.
BATHROOMS
Three Bedroom House
GARBAGE DISPOSAL UNIT
YES
❑
NO
❑
AUTO. DISHWASHER
YES
❑
NO
❑
AUTO. WASH. MACHINE
YES
❑
NO
Q
SITE SUITABLE
YES
❑
NO
❑
SIZE OF TANK
gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual �J Public ❑
IMPROVEMENTS PERMIT BY
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.
` P
INSTALLED BY C i1 ' (' n +
L'ERTIFIUATE OF UUMeLE'11U14 By ^...L� '�'�� _ - Date �� `/�•7�
(8/16/73) *Construction mus-o�mply with all other applicable State and local regulations
LOT AREA u �' (i a ✓_`.
I