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1501 Underpass Road Lot 14DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION 'NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c Sewage Treatment and Disposal Rules (10 NCAC 10A .19_34-.1968) Permit Number 'r Name ��` r.,x �`i s- C�,<<:7 L_l Date Location- - Subdivision Name Lot No, Sec. or Block No. Lot Size House Mobile Home. No. Bedrooms No. Baths No. in Family _ Garbage Disposal YES ❑ NO ❑ Auto Dish Washer YES ❑ NO ❑ Auto Wash Machine YES ❑ NO ❑ Type Water Supply__ - Business Speculation Specifications for System: "This Dermit Void if sewaae system-described..below-is-not-installed_within 36 months from date of issue. Improvements permit by—%`%'.�' f "Contact a representative of the Davie County Health Department for final inspection of this system between 8:30- 9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985. Final Installation Diagram: e Installed by� 15v. Certificate of Completion ��� Date 'The signing of this certificate shall indicate that the system describg above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. - T - . - " • -.v . ----.�.� ...v..- � 1,...tII tr.. -tr�w .�. .s. .. - -....w - —t - c � ... Y e. �` � - r - , - DAVIE. COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION "NOTE: Issued in Compliance With G.S; of North Carolina Chapter 130 Article 13c !'Sewage Treatment and Disposal Rules (10 NCAC 1.OA .1934-.1968) Permit Number Name K C Nn►£TN H b W f Ll- Date - O 3685 �� 3 I�oX 23DY+uc� 7 UIV 64r AS5 Subdivision Name 1.5 fit i 6t Lot No '`t RPS nr Rlnek Mn Lot Size House ✓ Mobile Home., Business No. Bedrooms No. Baths No.. in Family Speculation Garbage. Disposal YES fl NO ❑ Specifications for System: 9rz�FFf(L Auto Dish Washer YES E] NO ❑ t, / !� Auto Wash Machine YES ❑ NO ❑ Type Water Supply .Uprt7 *This permit Void if sews, iths from date of issue. Improvements permit by `Contact a representative of the Davie County Health Department for final inspection of this system between 8:30- 9:30 A.M. -or 1:00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985. Final Installation Diagram: e Installed by_013 = Certificate of Completion Date 'The signing of this certificate shall indicate that the system describ above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. - DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION "NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number_ Name Date Location— �. Subdivision Name ! rJ "' r r t Lot No. }< Sec. or Block No. Lot Size House t Mobile Home _ Business _— Speculation No. Bedrooms _ No. Baths _ _ No. in Family — Garbage Disposal YES ❑ NO ❑ Specifications for System: Auto Dish Washer YES ❑ NO ❑ Auto Wash Machine YES ❑ NO ❑ 7 ' i ✓l+ Type Water Supply__— "This permit Void if sewage system described blow-is-not-iastallad...within 36 months from date of issue. I i j L)tj� r _ Improvements permit by 2 Sr *Contact a representative of the Davie County Health Department for final inspection of this system between 8:30- 9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985. Final Installation Diagram: �_._—.-- System Installed bysLI `--rIlily-1N Certificate of Completion �.��-�� Date "The signing of this certificate shall indicate that the system described/ above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. ".R DAVIE COUNTY HEALTH DEPARTMENT r. (Septic Tank) Improvements Permit and Certificate of Completion (Ground Absor tion Sewage Disposal System - G.S. Chapter 130 -Article 13C) OWNER 0 CONTRACTOR �: , DATE 7-/9-77 PERMIT LOCATION �,,,f., pr„f,a r l� 1558 S.R. NO. SUBDIVISION NAME r.,r�t. LOT NO. jq SECTION OR BLOCK NO. HOUSE [I MOBILE HOME ❑ BUSINESS ❑ NO. BEDROOMS NO. BATHROOMS GARBAGE DISPOSAL UNIT YES ❑ NO ❑ AUTO. DISHWASHER YES ❑ NO ❑ AUTO. WASH. MACHINE YES ❑ NO ❑ SITE SUITABLE YES [I NO SIZE OF TANK 0cr O _ gal. NITRIFICATION FIELD 40-0 sq. ft. DEPTH OF STONE IN LINES: /2i41 -4 WATER SUPPLY: Individual ❑ Public J�'' House Trailer Two Bedroom House Three Bedroom House Four Bedroom House 800 Gal. 400 Sq. Ft. 800 Gal. 600 Sq. Ft. 900 Gal. 900 Sq. Ft. 1000 Gal. 1200 Sq. Ft. IMPROVEMENTS PERMIT BY.i C INSTALLED BYGt,✓ .S •% • CERTIFICATE OF COMPLETION By � CN!:n.J% Date //- 9- 77 (8/16/73) *Construction must 46mply with all other applicable State and local regulations LOT AREA ,n 0 DAVIE COUNTY HEALTH DEPARTMENT P. 0. BOX 57 MOCKSVILLE, N. C. 27028 (704) 634-5985 Statement for Septic Tank Improvement Permits and/or Site Evaluations NAME ]bAxj F4mIL DATE ISSUED 7/9-77 ADDRESS ��, � n, ���. PERMIT NO. k Explanation of charge AMOUNT DUE 4(,SANITARIAN 00? M" PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF AS STATEMENT.