345 Baileys Chapel Rd (2)CERTIFICATE OF COMPLETION
By Date
(8/16/73) *Construction must complywi h al yother applicable State'and local reg 1at:Y ns
LOT AREA
' DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter J30Article 13C)
OWNER OR CONTRACTOR �`` h'1rr.,p-„' DATE �' `` - i`':"'
PERMIT
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LOCATION : ,s' t.. }e -7'~ c. f�J`i /'/ !i e� �fJ� O'.,� �' �-•—,
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t.. N .
6 9
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/ S.R.
NO.
SUBDIVISION,NAME LOT NO. SECTION OR
BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
House Trailer 800
Gal. 400
Sq. Ft.
NO. BEDROOMS NO. BATHROOMS c
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 NO ❑ .
SITE SUITABLE YES NO ❑
SIZE OF TANK gal.
r,.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public
�f�r
/00
IMPROVEMENTS PERMIT BY �<.>., u ,E`
INSTALLED BY
CERTIFICATE OF COMPLETION
By Date
(8/16/73) *Construction must complywi h al yother applicable State'and local reg 1at:Y ns
LOT AREA