172 Overlook Drive Lot 14 Section 2DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION j
*NOTE: Issued in Compliance With Article II of G.S. Chapter 130a
Sanitary Sewage Systems Permit Number
Name-�- �' r7 lT.;/,'�� �j , Date /''?'•; /-• N2 v c,-
Location
Subdivision Name !' Lot No. -� `� Sec. or Block No.
Lot Size
House /f Mobile Home — Business _— Speculation
No. Bedrooms _� No. Baths -2 No. in Family 12
Garbage Disposal YES ❑ NO ❑-- Specifications for System:
Auto Dish Washer YES NO ❑
Auto Wash Machine YES NO ❑ �J
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.
Id
L
1/
Improvements permit by — d%
*Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram:
System Installed by
we r t)
Certificate of Completion --y�� Date
*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.
J �:
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DAVIE COUNTY HEALTH DEPARTMENT
---IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION '
_ *NOTE: Issued in Compliance With Article I I of G.S. Chapter 130a }
Sanitary Sewage Systems Permit Number
fame -T^ 'o-�' s , ,^� : i. ` _ i` " Date /'f - �r✓' NO �R r' 1` 2
Location
v.r r l tlC 1> �- /-1 �f 5%:� •E'_ `� 7 i - / h-/ 1-, 1 5
Subdivision Name ���'" = %'! Lot No. -- `, Sec. or Block No.
Lot Size House Mobile Home _ Business —_ Speculation
No. Bedrooms No. Bathsl_ ` No. in Family _
Garbage Disposal YES ❑ NO ❑ Specifications for System:
Auto Dish Washer YES y NO ❑ /
Auto Wash Machine YES L11 NO ❑ 1
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.
Improvements permit by — �`' o'
'Contact a representative of the Davie County Health Department for final 'inspection of -this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number: 704--634-5985.
Final Installation Diagram:
System Installed by
1,y GtJ
'iCertificate of Completion T-/! f!+ Date
"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
-(Septic Tank) Improvements Permit and Certificate of Completion
'(Ground Absorption Sewage Disposal System- G.S. Chapter'10- rticle 13C)
OWNER OR CONTRACTOR jr1%� �: f..+'.,�,/ c;. DATE "Jj�;r� PERMIT
�- N° 1812
LOCATION ��iC>% 5 �/�1��' l; .7,r i t , •
S.R. NO.
SUBDIVISION NAME LOT NO. 1 SECTION OR BLOCK NO.
HOUSE Cj �E HOME El BUSINESS ❑
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO M—
AUTO. DISHWASHER YES 2--L40 E]AUTO. WASH. MACHINE YES O' NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK /' gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public L!
IMPROVEMENTS PERMIT BY 1.
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
800 Gal. 400 Sq. Ft.
800 Gal. 600 Sq. Ft.
900 Gal. 900 Sq. Ft.
1000 Gal., 1200 Sq. Ft.
INSTALLED BY
CERTIFICATE OF COMPLETION::>By Date
(8/16/73) *Construction must comply with all other app icab1le State and Local regulations
LOT AREA / (�6� 4t L4 O��y
,5
��a a was'.
DAVIE COUNTY HEALTH DEPARTMENT
P. 0. BOX 57
MOCKSVILLE, N. C. 27028
(704) 634-5985
Statement for Septic Tank Improvement Permits
and/or Site Evaluations
NAME (���d )0Itle DATE ISSUED
ADDRESS PERMIT NO.
Explanation of charge
00
AMOUNT DUE �SANITARIAN
PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEMENT.