241 Overlook Drive Lot 6DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
Ground Absorption Sewage Disposal System - G.S. Chapter, 130 -Article 13C)
PER OR CONTRACTOR TfiC K Cg?A(J ):'Qk A DATE AlIS "r7 % PERMIT
LOCATION 1Lr ' u,✓, jr ? 1547
S.R. NO.
SUBDIVISION NAME � n�in/Oop � e -S LOT NO. $ SECTION OR BLOCK NO. j.
HOUSE D MOBILE HOME BUSINESS ❑
1 House Trailer -800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES 0 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 /,20 0, gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES: oZF
WATER SUPPLY: Individual ❑ Public ❑ oC .t.'t1 `
IMPROVEMENTS PERMIT BY INSTALLED BYa
CERTIFICATE OF COMPLETION By Date 11117122
(8/16/73) *Construction must oc mply with aIX other applicable State and local regulations..
LOT AREA
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I
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40W
DAVIE COUNTY HEALTH DEPARTMENT ���
P. 0. BOX 57
MOCKSVILLE, N. C. 27028 gj '(704) 634-5985
�a
Statement for Septic Tank Improvement Permits�p
and/or Site Evaluations J)
e �
NA14E DATE ISSUED
ADDRE S ,�� k �J PERMIT NO. �s
Explanation of charge
AMOUNT DUE1r'�- SANITARIA'�d Q:�
PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEf4ENT.