P62 Woodland�. DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption SWBge D7 --C
posal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR S �1-6 � h s t2_ DATE d? -- 13_ PERMIT
LOCATION
SUBDIVISION NAME
S. R. NO.
LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME, ❑ BUSINESS C
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES. ❑ NO ❑
AUTO..WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK Q gal.
NITRIFICATION FIELD % �`r� sq. ft.
DEPTH OF STONE IN LINES: /
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY
CERTIFICATE --OF COMPLETION eY---�
(8/16[73),. *Construction must c
LOT AREA
62
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. Sq. Ft.
Three Bedroom House 900 Gal. 4PSq.
Sq. Ft.
Four Bedroom House al. Ft.
INSTALLED BYPOUA-4 -P � i I / k
}fi�'''j�► Date c�, a
with all other applicable State and local regulations
_ DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR DATE PERMIT
LOCATION " ` N� 62
S.R. NO.
SUBDIVISION NAME �� ,1a`)c{ ��. c, LOT NO. SECTION OR BLOCK NO.
HOUSE W MOBILE HOME ❑ BUSINESS ❑
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK ga I.
NITRIFICATION FIELD j sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual,-� Public ❑
IMPROVEMENTS PERMIT BY ,' t fr
CERTIFICATE OF COMPLETION
BY—
(8/16/73) *Construction must
LOT AREA i
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800—Gal. -6M-.Sq. Ft.
Three Bedroom House 900 Gal.900jSq. Ft.
Four Bedroom House 1000 Gal. T200 Sq. Ft.
INSTALLED BY 6^ , /
f11
�f✓''�.,.� Date r1-__
with all other applicable State and local regulations