6748 Hwy 801SDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
P P
,(Ground Absorption Sewage Dioposal System - G.S. Chapter 130_ -Article 13C)
OWNER OR CONTRACTOR �,yi > t1 C `� `ti ` ° +l o+� DATE w 1 I PERMIT
LOCATION '> i1. 11"�i, i { _, :`,.i.�.,.. rte. ..� i. t� �� r .,. 2„ -E j ,h.. ,� t� ."' } 0 145
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE E3 MOBILE HOME ❑ BUSINESS ❑
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE 4 YES ❑ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD :�,c? sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY i = t- 'j` :'"►" _ ry r';'.;
House Trailer 800 Gal.
Two Bedroom House 400 -Gal.
Three Bedroom House
Four Bedroom House 1000 Gal.
r
a W-0, " Won
INSTALLED BY
400 Sq. Ft.
-(iGO—Sq—F
1200 Sq. Ft.
CERTIFICATE OF COMPLETION 1
By i Date (e-- - 13 " ;`�
(8/16/73) *Construction must o ply with all other applicable State and local regulations
LOT AREA
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-' DAVIE COUNTY HEALTH DEPARTMENT
j ,.:.,..(Septic Tank) Improvements -Permit and -Certificate, ofCompletion
Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER
ojlp,(Gr_ound
R CONTRACTOR 7� :,.t ; DATE PERMIT
LOCATION'Mi • �`��,rSC_Y `,.itC. Y•f..ia`i �.ort,e� 7t. r..�IC.- i L' N� 145
G'' Uc.1 r'�rL S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE 0 MOBILE HOME ❑ BUSINESS
NO. BEDROOMS 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 <.lr sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual x Public ❑
IMPROVEMENTS PERMIT BY �
House Trailer 800 Gal.
Two Bedroom House 80 gal.
Three Bedroom House
Four Bedroom House 1000 Gal.
s-r;iv9 %jGN�e+"
f /
INSTALLED BY
400 Sq. Ft.
00 S
1200 Sq. Ft.
CERTIFICATE OF COMPLETION By ' /,r 3
- Date �' - �
(8/16/73) *Construction must ply with all other applicable State and local rergulations
LOT AREA
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I{�r 1
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