708 Williams Rd (2)DAVIE COUNTY HEALTH DEPARTMENT 70 I YlJ
. (Septic Tank) Improvements Permit and Certificate of Completion
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(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR%i + <"r"` �r t'' ! tr r� td :' : ,j DATE PERMIT
No
LOCATION _ _ l ,�'rP' ' �yf...s,r�•;�,t, _ _. ;c� 370
U
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
NO. BEDROOMS N0. BA OOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINEYES ❑ NO ❑
SITE SUITABLE q M YES ❑ NO ❑
SIZE OF TANK al.
NITRIFICATION FIELD SID sq. ft.
DEPTH OF STONE IN LINES: =T
WATER SUPPLY: IndividualI.
V,, Public [3IMPROVEMENTS PERMIT BY J/',
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
x800—Ga 400.,,Sq.:
900 Gal. 900 Sq. Ft.
1000 Gal. 1200 Sq. Ft.
INSTALLED BY &&S t -S.'
CERTIFICATE OF COMPLETION By_Vj-� Date f!L! `7�
(8/16/73) *Construction must omply with all other applicable State and local regulations
LOT AREA ;