184 Kennen Krest Rd' DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Abso ptipaxSewage �spAolf''.4.orl System - G.S. Chapter 130-A tiple 13C)
OWNER OR CONTRACTOR 1 , .g" ' �f" C)► ' DATE ''V — • •,•PERMIT
11 N° 173
LOCATION !` f tf7`in r' `. w r. )/"1 E'E+�i d 4 J/ a `L 4 -to i
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE A MOBILE HOME BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS Two Bedroom House 8 al 60 Ft.
GARBAGE DISPOSAL UNIT YES NO 14 Three Bedroom House 0 aQ,,,Ft,j
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 J. �Public
IMPROVEMENTS PERMIT BY r, ❑ INSTALLED BY¢
�
CERTIFICATE OF COMPLETION By 4 .Q,rb+'s,';� ,,,ti Datek
(8/16/73) *Construction must cor&�ly with all other applicable State and local regulations
LOT AREA