344 Martin Luther King Junior RdDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absor ion Sewag ispo'saf'System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR DATE — ? PERMIT
LOCATION N? 1203
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME t3 BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BE ROOMS NO. BATHROOMS �_ Two Bedroom House LE0 Atea. 600 Sq. fit.
GARBAGE DISPOSAL UNIT YES ❑ NO [ Three Bedroom House 900 Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES ❑ NOW¢},i Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ED
SITE SUITABLE YES [H' NO ❑
SIZE OF TANK 57040 ga 1.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public
IMPROVEMENTS PERMIT BY
INSTALLED BY Qj' 0 ,,,b- Fr�
CERTIFICATE OF COMPLETION
BY Date 6 "-21' 7 �?
(8/16/73) *Construction must compfy with all other applicable State and local regulations
LOT AREA
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 �""_-.,-,�.Q-* DATE--, ^ - �J CP PERMIT
LOCATION
i j`E-- J\
SUBDIVISION NAME
LOT NO.
HOUSE A MOBILE HOME ❑ BUSINESS I
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO
AUTO. DISHWASHER YES ❑ NO
AUTO. WASH. MACHINE YES ❑ NO
SITE SUITABLE --, YES 0— NO ❑
SIZE OF TANK 0d.3 gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public
IMPROVEMENTS PERMIT BY
S. R. NO.
SECTION OR BLOCK NO.
1203
House Trailer 800 Gal. 400 S Ft.
Two Bedroom House 800 Gal �OOg,
Three Bedroom House 900 Gal. 900 Sq. Ft.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
INSTALLED BY rJ B 4 -
CERTIFICATE OF COMPLETION By � Date
(8/16/73) *Construction must comply wit all other applicable State and local regulations
LOT AREA