7482 Hwy 801S Y �
`1 DAVIE COUNTY HEALTH DEPARTMENT
. I (Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter PO-,Article 13C)
ReER OR CONTRACTOR U1p g }�URAI DATE 19111a177 PERMIT
LOCATION N? 1714
- - - S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSEMOBILE HOME BUSINESS
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO 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 gal. �y J
NITRIFICATION FIELD sq. ft. v r
DEPTH OF STONE IN LINES: _ L
WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BY INSTALLED BY
CERTIFICATE OF COMPLETION
By Date
(8/16/73) *Construction must comply wit ll other ap ablejState and local regulations
LOT AREA
s
DAVIE COUNTY HEALTH DEPARTMENT '
ir-V (Septic Tank) Improvements Permit and Certificate of Completion
y� (Ground Absorption Sewage Disposal System - G.S. Chapter 0-Article 13C)
DOWNER OR.CONTR.ACTOR fl ur7 t j/I.JkN DATE /-,?AK 7 7 PERMIT
LOCATION- r,S` 7Q� ty,: !�t+t�� { !' �- N:O 1714
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
House Trailer 800 Gala 400 Sq. Ft.
NO. BEDROOMS N0. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House 900 Gala 900 Sq. Ft.
AUTO. DISHWASHER YES ❑ NO Q Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH._ MACHINE YES ❑ NO ❑ w� f +� t.�-.;�'
SITE SUITABLE YES ❑ NO ❑ ,
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft. ,
DEPTH OF STONE IN LINES: 4 c -';,.f✓ .,
WATER SUPPLY: Individual ❑ Public ❑ .. f
IMPROVEMENTS PERMIT BY " INSTALLED BY
WO 71
CERTIFICATE OF COMPLETION By f Date
(8/16/73) *Construction must comply wit other app 1 State and local regulations
LOT AREA
j
50
a 16,11
1.
o�60
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i
DAVIE COUNTY HEALTH DEPARTMENT
` t (Septic Tank) Lnprovements Permit and Certificate of Completion
(Ground Absorption Sewage bisposal System G.S. Chapter 0-Art c. 13C)
s`
ER OR CONTRACTOR (,C/7 t�D hORN DATE .I a to PERMIT
LOCATION 114'
S.R., N0.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK N0. `
f HOUSE MOBILE HO!!E BUSINESS ❑ f '
House Trailer 800 Gal. . 400' Sq . ,Ft 3`
N0.',.BEDROOMS '_ NO.:'BATHROOKS
Two Bedroom. House 800.6al 600'."Sq.. ,Fe`;,
GARBAGE DISPOSAL'.
YES ❑ ' NO Three Bedroom House- 900 Gal. 900'sq. 'Ft
:AUTO,L,DISHWASHER . YES ❑ NO Four Bedroom.House 1000 Gal'. _ 1200 ;Sq Ft
AUTO, WASH. MACHINE`. YES .❑ NO
SITE SUITABLE :; YES 13 N0
SIZE OF TANK gal.. . rti
ft
NITRIFICATION FIELD Q
DEPTH OF STONE IN LINES t _ i y� ..
- c[. D G J' ' 'i'r`e!/ � �#d
WATER SUPPLYs � Individual ❑ Public [3
_:.-. r
IMPROVEMENTS PERMIT BY INSTALLED :BY
CERTIFICATE. OF *COMPLETION
By Date
(8/16/73) *Construction must c000ply with All other applicable"State''and local 'regulations
LOT AREA _
W QA