P1746 Wood Valley Lot 5DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNEROR CONTRAC R_ s j t; DATE PERMIT
1- N° 1746
LOCAT =- `1 !� l! i f��a i (�� � Lt'"� .��.�-:.� raw '
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME U BUSINESS U
NO. BEDROOMS .!) NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO C7r
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES D NO ❑
SITE SUITABLE YES CJ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual �` Public ❑
IMPROVEMENTS PERMIT BY
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 107700 Gal. 1200 Sq. Ft.
1
INSTALLED BY
CERTIFICATE OF COMPLETION By �C. Date
(8/16/73) *Construction must comply with /all other applicable State and local regulations
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LOT AREA
i
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DAVIE COUNTY HEALTH DEPARTMENT
Statement for
and/or
P. 0. BOX 57
MOCKSVILLE, N. C. 27028
(704) 634-5985
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Septic Tank,Improvement Permits
Site Evaluations
NAP�;E ( DATE ISSUED
ADDRESS ���� % _� �� PERMIT NO. 1 �
~' n
Explanation of charge
AMOUNT DUEe�r SANITARIAN �-
PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEM T.