P1998 Farmington RdDAVIE 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 t , t •`.' ('. } `` , i t DATE ✓'" r %" PERMIT
-- ,
LOCATION '� : �:, w: ' J N? 1998
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOU
BUSINESS
CERTIFICA
(8/16/73)
LOT AREA
OF COMPLETION By
*Construction must comply with all o
Date
applicable State and local regulations
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
❑
NO
::,:
SITE SUITABLE
YES
❑
NO ❑
SIZE OF TANK
gal.
NITRIFICATION FIELD
sq. ft.
=`> .' . -. "` • �A "'
` `
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual
❑
Public ❑
IMPROVEMENTS PERMIT BY
INSTALLED BY ,►; i .,..:
: • 7,
CERTIFICA
(8/16/73)
LOT AREA
OF COMPLETION By
*Construction must comply with all o
Date
applicable State and local regulations
DAVIE COUNTY HEALTH DEPARTMENT
P. 0. BOX 57
HOCKSVILLE, N. C. 27028
(704) 634-5985
e
Statement for Septic Tank Improvement Permits
and/or Site Evaluations
NAME;; -'i,- ': � ;; ,�_ �� ,��/•�, DATE ISSUED
ADDRESS `S^ .,4/;�,1 j�� PERMIT NO.
Explanation of charge /-�„/, r, L.�-� 1 - ,'��� �, ���r�•�%� _'�
AMOUNT DUE' c/y
SANITARIAN ` • � rte;=-- �-)
PLEASE RE14IT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEMENT.