189 Sparks Rd (2)_ Y DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System G.S. Chapter 130 -Article 13C)
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OWNER OR CONTRACTOR , DATE a_7�" PERMIT
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LOCATION "c_ b-° j 't f f N9
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SUBDIVISION NAME LOT NO. SECTION OR"`BLOCK NO.
HOUSE ❑ MOBILE HOME 0 BUSINESS ❑
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO
AUTO. DISHWASHER YES ❑ NO Q_--
AUTO. WASH. MACHINE YES M-"" NO ❑
SITE SUITABLE YES ED-` NO ❑
SIZE OF TANK gal.,
NITRIFICATION FIELD ft.
DEPTH OF STONE IN LINES: ,yt 'r-11
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WATER SUPPLY: Individual Public ❑
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IMPROVEMENTS PERMIT BY 1� r_._ Tr i'`✓Lz�_m-&t
House Trailer
800 Gal.
Two Bedroom House
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Three Bedroom House
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Four Bedroom House
1000 Gal.
INSTALLED BY
400 Sg. Ft.
600 Sq. Ft"
1200 Sq. Ft.
CERTIFICATE OF COMPLETION By Date
(8/16/73) *Construction must COW with a 1 other appl cable State and loca regulations
LOT AREA! ,
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