P551 Todd Rdr DAVIE COUNTY.HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate "of Completion
(Ground Absorption Sewage Disposal
System..-,G.S. Chapter 130 -Article
13C)
MWNFR%OR CONTRACTOR �_ .i.
DATE .-
PERMIT
1 " i
' - :.
1� 551
LOCATION �.. ,' :,, ,.. ,
,>
S.R.
NO. tb V
SUBDIVISION NAME LOT NO. SECTION OR
BLOCK NO.
HOUSE ❑ MOBILE HOME tj BUSINESS
❑
House Trailer 800
Gal. 400 Sq. Ft.
N0. BEDROOMS N0. BATHROOMS
Two Bedroom House 800
Gal. 600._.Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
Three Bedroom House (,.900
Gala 900 Sq. Ft."'
AUTO. DISHWASHER YES ❑ NO ❑
Four Bedroom House 1000
Gal. _lq_ F .
AUTO. WASH. MACHINE YES ❑ NO ❑
r < f T
SITE SUITABLE YES ❑ NO ❑
,«
�� "` ` ' ► I
+
SIZE OF TANK , :J gal. , •
..
.rte, " / .
t
% a ft
NITRIFICATION FIELD sq:
`
DEPTH OF STONE IN LINES: {s /ETA— i }"
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY
,�
INSTALLED BY
CERTIFICATE OF COMPLETION By , {j,�,i.G,�.� Date
(8/16/73) *Construction must comply Y,;�th all other applicable State and local regulations
LOT AREA.�''•;)C �+ a
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