P772 Wall St DAVIE COUNTY,HE .LTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion ^
(Ground Absorption Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR FDATE 4 +`b- a7-75- PERMIT
LOCATION l: e e - - �.�r cn r .�.�_ ? r( / 2
t'ry► C i..c1 . S.R. NO. //,So
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS Two Bedroom House 0Ga 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House 9 Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑ L 1;'--C- k
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal. �n h�^+st.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN. LINES
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY INSTALLED BY Dq„; c, S;T C.z,
CERTIFICATE OF COMPLETION
By ,-XVr- Date 1X- IL,-7S-
(8/16/73) *Construction must c mply with all other applicable State and local regulations
LOT AREA
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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 ,}tl�n � r y,.y, DATE ,/I)- -:,P7- 7 PERMIT
N°� '772
LOCATIONi e atr ll�r A.a -�r ,(•� �.Yt�� (' �i ,r 1�rn.:o:c. c'}r,-s �e . •
r
S.R. NO. //36
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ( MOBILE HOME BUSINESS ❑
House Trailer 800 Gal. .400 Sq. Ft.
NO. BEDROOMS NO. . BATHROOMS
. Two Bedroom House �00G 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House 900 Sq. Ft.
AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES '❑ NO ❑
SIZE OF TANK ga 1. C.-
NITRIFICATION FIELD e � sq. . ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual V Public ❑
t IMPROVEMENTS PERMIT BY C\nA, + INSTALLED BY
CERTIFICATE OF COMPLETION By Date '71
(8/16/73) *Construction must c mply with all other, applicable State and local regulations
LOT AREA
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