249 Cedar Grove Church RdR
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 j . . �}� =y" r '` �' .y x, r`f l f DATEo .. .r / X -�-'
1 PERMIT
-_ 241
LOCATION
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ,(Sj MOBILE HOME BUSINESS ❑
r .I-` House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS _ NO. BATHROOMS 0 Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO Three Bedroom House 9Q0-Gaoln _cj.00--Sq,-F.t,
AUTO. DISHWASHER YES (n'`',NO ❑ Four Bedroom House 11000 Gal. 1200 ,�•c},�Ft,;,
AUTO. WASH. MACHINE YES I! ,-,,NO ❑
SITE SUITABLE YES [ NO rl
SIZE OF TANK gal. ��a5 5 /6,,-;z�e
Y NITRIFICATION FIELD sq. ft.�',� �;•f'
DEPTH OF STONE IN LINES:
0�
WATER SUPPLY: Individual Q. _Pub�l1c. ❑ If
IMPROVEMENTS PERMIT BYr`--.d. INSTALLED BYE,C/`
CERTIFICATE OF COMPLETION r-' q.•- --
By `�' ' �-'��- Date
(8/16/73) *Construction must'compty with all other applicable State and local regulations
LOT AREA
,- 40 41n
. 1
i
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