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308 Pino Rd DAVIE COUNTY HEALTH DEPARTMENT (Septic Tank) Improvements Permit land Certificate of Completion (Ground Absorption Sewage,_Disposal System - G.S. Chapter/ 130-Article_ 13C) f % %1.-''c.c<;:..cL -- DATE �� PERMIT OWNER OR CONTRACTOR _r ' , p LOCATION ID �.. I dYL N? 1 0 6 3 ru S.R. NO. SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO. HOUSE ❑ MOBILE HOME BUSINESS ❑ N0. BEDROOMS X'" N0. BATHROOMS House Trailer 800 Gal. 400 Sq. Ft. 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 M ' Four Bedroom House 1000 Gal. ' 1200 Sq. Ft. AUTO. WASH. MACHINE YES 5-'NO ❑ SITE SUITABLE YES ❑ NO ❑ .'j �. '.;i r.r` :••^i r. ,.7"�:' <.,. 0 SIZE OF TANK gal. NITRIFICATION FIELD sq. ft. DEPTH OF STONE IN LIN(/ES: WATER SUPPLY: Individual_} ❑ Public ❑ IMPROVEMENTS PERMIT BY I , . r'4...'.t',f1 I INSTALLED BY CERTIFICATE OF COMPLETIONBY �� Date 9 fl (8/16/73) *Construction must comply with all other applicable State and. local regulatif'ns LOT AREA T ti DAVIE COUNTY HEALTH DEPARTMENT , / P. 0. BOX 57 e� U HOCKSVILLE, N. C. 27028 (704) 634-59.85 Statement for Septic Tank Improvement Permits �y and/or ' te ,Evaluations _ 7 , NAME DATE ISSUED ADDRESS PERMIT NO. -270 � Explanation of ar e P S . 40UNT DUE/S-' SANITARIAN ✓ PLEASE NAEMIT THE ABOVE AlkOUNT ON RECEIPT OF THIS STATEbiE T.