P220 Foster Rd+ DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage
--
,DispoSal,pystem - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR j,' ��'1:+� .'%. !� .(:•� �n�.?�j DATE rj -y- PERMIT
LOCATION ?c. r »!, /'•'i c',S 1 4J c4
/
S. R. NO. /i
SUBDIVISION NAME
LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HpEBUSINESS
Jo;' ,6 f0 IN'1'
NO. BEDROOMS NO.F BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO C9'"w
AUTO. DISHWASHER YES ,.❑�,r,NO Q�
AUTO. WASH. MACHINE YES t=Tr,, NO ❑
SITE SUITABLE YES [ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ^p Public ❑
IMPROVEMENTS PERMIT BY - ' f .�.�•`*^
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
INSTALLED
220
800 Gal. 400 Sq. Ft.
0 Gal.1-cm F.J1
jSS Ft.
90_ o...,�Ft�.
1000 Gal. 1200 Sq. ;.
CERTIFICATE OF COMPLETION By ! ' , d��r� Date'-2.4'-�,
(8/16/73) *Construction must co, y'with all other applicable ,State and local regulations
LOT AREA
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41/ '' C.
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