164 Westridge Road Lot 41DAVIE 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 i Date �1117
Location
Subdivision Name �� �/Y 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 ❑ ��( X-3 (�
Auto Wash Machine YES ❑ NO ❑
Type Water Supply __—
"This permit Void if sewage system described bel is not installed within
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 \by _�
Certificate of Completion Date /
"The signing of this certificate shall indicate that the system described above has been installed in comp iance 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
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 by
Certificate of Completion 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 Absor. ion Sewage Di osal S stem - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR DATE PERMIT
LOCATION N9 989
S.R. NO.
SUBDIVISION NAME 1 LOT NO. '" A SECTION OR BLOCK NO.
HOUSE )Z� MOBILE HOME ❑ BUSINESS C
NO. BZDROOMS NO. BATHROOMS cQ
GARBAGE DISPOSAL UNIT YES NO ❑
AUTO. DISHWASHER YES NO ❑
AUTO. WASH. MACHINE YES NO ❑
SITE SUITABLE YES NO ❑
SIZE OF TANK gal: '-
NITRIFICATION FIELD 'r IPsq. ft.
DEPTH OF STONE IN LINES: -' "
WATER SUPPLY: Individual ❑ P blic ❑
IMPROVEMENTS PERMIT BY L'L
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.
3 L1 )Ue-,57 /6d '*X 3`
INSTALLED BY
CERTIFICATE OF COMPLETION By Date�—P^2- 96
(8/16/73) *Construction must compl with all other applicable State and local regulations
LOT AREA
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