340 Howardtown Rd (3) DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal --3'ys'rem G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR DATE /,,--,x 1-7 PERMIT
LOCATION '77 1362
2 S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME BUSINESS [:]
'j House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES El NO D- Three Bedroom House 900 Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES NO 0 Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES NO M
SITE SUITABLE YES [3 NO [3
-77
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY"-)f;,-' 1*1'N,-jl.'-1117 INSTALLED BY L,Q, rAot—.
CERTIFICATE OF COMPLETION y .. Date
must co�
ply
with
all other
applicable
abje�
State
(8/16/73) *Construction and local regulations
LOT AREA 0
?r Z. $1
ED
DAVIE COUNTY HEALTH DEPARTMENT
i, (Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR CO'NtTRACTOR 7r4c� Yl'�r�rs�DA+�C DATE .2,s PERMIT
LOCATION H6LQcLt-1�71�►1 RcQ-- �'�T 1�Rni- '(lt�., �cr,s� c1•. �� �as�' lr� 1362
T -,7.le-r n.;Jc- c,t=P S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE P MOBILE HOME tj BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS a Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO 0- Three Bedroom House 900 Gal. 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 ?6rz) gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual A Public ❑
IMPROVEMENTS PERMIT BY INSTALLED BY
CERTIFICATE OF COMPLETION
By Date
(8/16/73) *Construction must comply with all other applicable State and local regulations
LOT AREA 12- RCr e
t �
� t
,