P1984 Baity's WeldingDAVIE 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 7'!
DATE PERMIT
LOCATION 1894
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE Lj MOBILE HOME Ll
BUSINESS
0
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 rj-
SITE SUITABLE YES 0
NO [3
SIZE OF TANK gal.
NITRIFICATION FIELD
sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual 0
Public
IMPROVEMENTS PERMIT BY
INSTALLED BY
CERTIFICATE OF COMPLETION By
Date 7'
(8/16/73) *Construction must
comply with
all other applicable State and
local
regulations
LOT AREA
DAVIE COUNTY HEALTH DEPARTMENT
P. 0. BOX 57 71 f!%�
HOCKSVILLE, N. C. 27028 /
(704) 634-5985
S atement for Septic Tank Improvement Permits
and/or Site Evaluations
NAME 1 � -}r Gj�,��i:f DATE ISSUED
ADDRESS
N0.
Explanation of charge �1
AMOUNT DUE,2 _ � SANITARIAN
PLEASE REMIIT THE ABOVE AMOUNT ON -P.ECEIPT -OF THIS STATE TENT.