Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
P1666 Hwy 801
• - DAVIE COUNTY HEALTH DEPARTMENT (Septic Tank) Improvements Permit and Certificate of Completion (Ground Absorption Sewage Disposal ,Syq 9m - G.S. Chaptye�rr 130r�-Article 13C) OWNER OR CONTRACTOR,"�°J�,�t'!' ti "a DATE !CX,�,/"/�' PERMIT T" r • J � LOCATION " `t1 f 3I� {,� ti�`f ' !�+rl1 l� . S. R. NO. SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO. HOUSE ©' MOBILE HOME ❑ BUSINESS ❑ NO. BEDROOMS 9 NO. BATHROOMS GARBAGE DISPOSAL UNIT YES ❑ ,,NO ff' AUTO. DISHWASHER YES [-�"' N0. ❑ AUTO. WASH. MACHINE YES ( NO ❑ SITE SUITABLE//,,, YES ❑ NO ❑ SIZE OF TANK 6 gal. NITRIFICATION FIELD sq. ft. �< DEPTH OF STONE IN LINES: !� `fir WATER SUPPLY: Individua(l� ❑,%� Public ❑ IMPROVEMENTS PERMIT BY 1666 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 1000 Gal. 1200 Sq. Ft. f 44..aa 1! ii J INSTALLED BYC��:..r CERTIFICATE OF COMPLETION ByDael,7 Date 6 ; 70 (8/16/73) *Construction mus comply with all other applicable State and local regulations LOT AREA t Ak DAVIE COUNTY HEALTH DEPARTMENT P. 0. BOX 57 HOCKSVILLE, N. C. 27023 (704) 634-5985 77 Statement for Septic Tank Improvement Permits l and/or Site Evaluations NAME l/i i'` (% IC// ��%1�.1 '1'L/ f� -'y` j -DATE ISSUED ; I�� ADDRESS ! PERMIT NO. i Explanation of charge }} AMOUNT DUE SANITARIAN PLEASE REMMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEMENT.