P1632 Greenhill RdAdW
DAVIE COUNTY HEALTH DEPARTMENT G--CeeNhI11
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTORDATE ;' fi PERMIT
J n
LOCATION ityu��cl/ 2G+�' N� 1632
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME p 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 gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BY !�
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. 600 Sq. Ft.
Three Bedroom House 900 Gal. 900 Sq. Ft.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
INSTALLED BY-- 1 1J1C- �'• �' Com'
CERTIFICATE OF COMPLETION Date
(8/16/73) *Construction must Amply with all other applicable State and local regulations
LOT AREA
S�>C,C
�c c r u • 1i five-
.:� - a. " - -r �'