166 Edward Beck Rd (2) DAVIE COUNTY HEALTH DEPARTMENT
x (Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR jj'��L. � tJ['C t DATE 77 PERMIT
LOCATION 1305
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO. '
HOUSE ❑ MOBILE HOME BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
N0. BEDROOMS N0. 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 22 Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES NO ❑
SITE SUITABLE G YES ( NO ❑ i�sf4/Ncf /,27/77D4) sca insfo/%yO'`
SIZE OF TANK f 0D gal. (`ori F/%c ;n
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES: Jf"Ietel
WATER SUPPLY: Individual ❑ Public ❑ 1�-
IMPROVEMENTS PERMIT BY ` _ �'�'1Ly.c0 INSTALLED BY F,4,4NKA,pnhA,Qr1T
CERTIFICATE OF COMPLETION BY �� ID Data,2 7
7
(8/16/73) *Construction must c ply with all other applicable State and local regulations
LOT AREA
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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 'BeCe DATE ///3 '7'7 PERMIT
LOCATION Ch r -' 'cL . OK '�• ` s - a6�� hie- pN? 1305
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
NO. BEDROOMSN0. 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 N3 Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES NO ❑
SITE SUITABLE p YES J�( NO ❑
SIZE OF TANK -<6V gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BY INSTALLED BY
CERTIFICATE OF COMPLETION
BY Date
(8/16/73) *Construction must comply with all other applicable State and local regulations
LOT AREA
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