151 Austine Lane Lots 29-3077;V
DAVIE -COUNTY fEALTH DEPARTMENT
,t
IMPROVEMENTS PERMIT AND. CERTIFICATE OF COMPLETION
*.NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a
Sanitary Sewage'Systeemms j Permit Number
-Name�{� 1?/. et a �.t1 '! / �, Date -'�,�1 �X — N2 6417.
Location • :�/�r�...':
Subdivision. Name Lot No. Sec. or Block No.
Lot Size House Mobile Home _ Business Speculation
No. Bedrooms' No. Baths __ No. in Family_
Garbage Disposal YES. ❑ NO ®r'' Specifications for System:
Auto Dish Washer, YES NO ❑ e
Auto'Wash. Ma shine YES NO ❑
Type Water Supply
'This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
+'Contact a representative of the Davie County Health Department for final inspection of this systerk..'I:etween 8:30-
9:30 -A.M. or 1:00-1:30 P.M. on day of completion. Teleph, Qne Number -704-634-5985.
Final Installation Diagram:
ed by Qt/!I� mi4N �Ac Cii e-e�
Certificate of Completion (. Date G
'The signing of this certificate shall indicate that the system,: described above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be'taken as a guarantee that the system will function
satisfactorily for any given period of.time.
DAVIE COUNTY .HEALTH :DEPARTMENT " 'w
.. , .
(Septic Tank) Improvements Permit,m d-Certificate of Completion
(Ground Absorption Sewage Disposal ;System - G.S., Chapter 130-Article 13C) ,
OWNE. a R CONTRACTOR , 6?' e"'�,_.. 4 ,n, G.,r,"��1@¢. DATE ,� `I` PERMIT
i. No
,LOCATION C'.;t? a'? ''!� o ?,' �� ►r, ,k 426
S.R. 'NO.
SUBDIVISION. NAME j6p.eN (', ' {u+r. LOT NO. SECTION OR BLOCK N0. .
HOUSE ❑: MOBILE HOME BUSINESS ❑
House .Trailer 800 Gal. 400 Sq. Ft.
-NO. 1BEDR00MS NO. BATHROOMS Two Bedroom House" 8 6,PQ—S+—,F t
Three Bedroom House 9 : �0 Sq. F
GARBAGE DISPOSAL"UNIT YES ❑ NO ❑ , .
'. ' AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 1000 Gal. 12"00 Sq. Ft.
AUTO. WASH. MACHINE', YES ❑ NO ❑
SITE SUITABLE YES ❑ N
SIZE, OF TANK gal.'
NITRIFICATION FIELD , sq. ft.j .
j..
DEPTH OF STONE IN LINES: 4ir`" ./G1r?,.p
WATER. SUPPLY Individual Public ❑ ll
"= IMPROVEMENTS PERMIT BY ,,�, + -4t ,I0 INSTALLED BY _ NoOoar (91"oo- m(r"
t CERTIFICATE OF COMPLETION By Date /01
(8/16/73) *Construction must "c ly with all other applicable State and local regulations
1 ' LOT (AREA
• 6.. - y