128 Westridge Road Lot 37DAVIE COUNTY,, HEALTH DEPARTMENT
T IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
'Note: Issued in Compliance with G'S. of North Carolina Chapter 130—Article 13c.
t Permit Number
Name Date 2:623
Location wESf �� cue e. 1
J- '
Subdivision Name uLoft No. Seca or Block No.
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
'Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name _ Date
Location
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 ❑ Specifications for System:
Auto Dish Washer YES ❑ NO ❑
Auto Wash Machine YES ❑ NO ❑
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
Improvements permit by
*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 bye �T�T3
3-f3 fSl
Certificate of Completion — Date IV
*The signing of this certificate shall indicate that the system describ d 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
y "(Ground Absorption Sewage Dl!isposal�System - G.S. Chapter 130 -Article 13C)
O�TNER OR CONTRACTOR + .' iy�+:I4Do DATE to est,t-ll. PERMIT
iocATloN�aS N° .1199
S.R. NO.
SUBDIVISION NAME '� sc`.e r .; LOT N0. " SECTION OR BLOCK NO.
HOUSE MOBILE HOME ❑ BUSINESS 1:1
N0: BEDROOMS W? NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES' ❑ NO
AUTO. DISHWASHER 'YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
'SITE'SUITABLE YES "❑ NO ❑.
SIZE OF TANK ja cSa gal.
NITRIFICATION FIELD sq. ft.,
DEPTH OF STONE IN LINES s
WATER.SUPPLY: Individual Public ❑'°'
IMPROVEMENTS PERMIT BY gLse�
House Trailer 800 Gal.. 400
Sq. Ft.
Two Bedroom House 800 Gal.' 600
Sq. Ft.
Three Bedroom House' 900 Gal. 900
Sq. Ft.
Four Bedroom House 1000 Gal. ,1200
Sq:. Ft.
INSTALLED- BY . Q y-�
`
r / DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
„ ,(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR ::S . M . DATE 1 a a 1 It. PERMIT
LOCATION l.�r�elt ���SSfico N? 1199
S.R. NO.
SUBDIVISION NAME We.sTv,,aSe LOT NO. SECTION OR BLOCK NO.
HOUSE ® MOBILE HOME ❑ BUSINESS
NO. BEDROOMS .3 NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ® Public ❑
IMPROVEMENTS PERMIT BY
House Trailer
800
Gal.
400
Sq.
Ft.
Two Bedroom House
800
Gal.
600
Sq.
Ft.
Three Bedroom House
900
Gal.
900
Sq.
Ft.
Four Bedroom House
1000
Gal.
1200
Sq.
Ft.
INSTALLED BY
CERTIFICATE OF COMPLETION By Date
(8/16/73) *Construction must comply with all other applicable State and local regulations
LOT AREA
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