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165 Westridge Road Lot 28Y YY 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 DATE -, 7" PERMIT �- - - -- LOCATION N9 1844 S.R. NO. SUBDIVISION NAME -'7T,,: LOT NO. = `! SECTION OR BLOCK NO. HOUSE MOBILE HOME E3 BUSINESS ❑ House Trailer 800 Gal. 400 Sq. Ft. NO. BEDROOMS = NO. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft. GARBAGE DISPOSAL UNIT YES ❑ 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 C�' NO ❑ SITE SUITABLE YES [ NO ❑ SIZE OF TANK gal. NITRIFICATION FIELD sq. ft. DEPTH OF STONE IN LINES: WATER SUPPLY: Individual ❑ Public [' ell -y IMPROVEMENTS PERMIT BY :,a..-. INSTALLED BY CERTIFICATE (8/16/73) LOT AREA OF COMPLETION ^Q� By *Construction must comply with Date �,-4' 3 /7,r other applicable State and local regu ations DAVIE COUNTY HEALTH DEPARTMENT (Septic Tank) Improvements Permit and Certificate of Completion (Ground Absorption Sewage Disposal System - G.S. Chapter 1 0 -Art jce 13C) OWNER OR CONTRACTOR J V �apATE PERMIT LOCATION �';' ' y,t�z , N? 1692 S.R. NO. SUBDIVISION NAMEe=z t , - --t LOT N0. ca� SECTION OR BLOCK N0. HOUSE [ ' MOBILE HOME ❑ BUSINESS NO. BEDROOMS --? NO. BATHROOMS Z GARBAGE DISPOSAL UNIT YES ❑ NO 0 - AUTO. DISHWASHER YES [2' NO ❑ AUTO. WASH. MACHINE YES L -Y 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 Ute_ // /r7�i CERTIFICA (8/16/73) LOT AREA 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 OF COMPLETION By Date *Construction must comply with all other applicable State and local regulations DAVIE COUNTY HEALTH DEPARTMENT (Septic Tank) Improvements Permit and Certificate of Completion (Ground Absorpt on Sewage D sposal System - G.S. Chapter 1 0 -Art a 13C) OWNER OR CONTRACTOR Q ATE o o7DPERMIT VVF LOCATIONS N9 1692 �y S.R. NO. SUBDIVISION NAME LOT NO. o�-'Q SECTION OR BLOCK NO. HOUSE � MOBILE HONE ❑ BUSINESS NO. BEDROOMS v? NO. BATHROOMS ;?- GARBAGE DISPOSAL UNIT YES ❑ NO ',Cr, AUTO. DISHWASHER 'YES NO a❑ AUTO. WASH. MACHINE YES Q' NO ❑ SITE SUITABLE YES NO SIZE OF TANK gal. {❑ NITRIFICATION FIELD sq. ft. DEPTH OF STONE IN LINES: WATER SUPPLY: Individual ❑ Public la 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. r Z !L A -Z IMPROVEMENTS PERMIT BY t,J /% JQjr�pD INSTALLED BY CERTIFICATE OF COMPLETION By Date (8/16/73) *Construction must comply with all other applicable State and local regulations LOT AREA DAVIE COUNTY HEALTH DEPARTMENT P. 0. BOX 57 HOCKSVILLE, N. C. 27028 (704) 634-5985 Statement for Septic Tank Improvement Permits and/or Site Evaluations NAME ADDRESS Pe).13,1 ge Explanation of charge DATE ISSUED,-?,/,?,,Zd' PERMIT NO. /b 9-7- AMOUNT Q? AMOUNT DUE!/S." SANITARIAN Q./7),2 ,GAJ v PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEMENT.