1529 Underpass Road Lot 11DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE- OF COMPLETION 30E: Issued in Compliance;with G.S..of. North -Carolina Chapter 130 Article 13c
Sewage Treatment. and Disposal Rules (10.,NCAC •10A .19347..1968) Permit Number
Name 'i l�.f.�c'` Date �� 3683
,✓
Location
Subdivision Name Uy d,(' Lot No. Sec. or Block No.
Lot Size House l/�: Mobile'Home _ Business Speculation
No. Bedrooms, -7 No. Baths ._ _ No. in Family
Garbage Disposal YES .0 NO ❑ Specifications for System:'
Auto Dish Washer YES ❑ NO
Auto Wash Machine YES ❑ NO C]
Type Water Supply
`'This permit Void 'if sewage system described below is not instalITI within 36 months from date of issue.
ae
►
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. -
J
Final Installatio6 Diagram: System Installed by
X i
Certificate of Completion Date �` •y' %. '�
'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.
I 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
i Name Date _
Location r,,�` x,�.���
'
Subdivision Name r -r' Lot No. Sec. or Block No.
Lot Size
No. Bedrooms
Garbage Disposal
Auto Dish Washer
Auto Wash Machine
Type Water Supply
House _" Mobile Home
_ No. Baths _ _ No. in Family
YES ❑ NO ❑
YES ❑ NO ❑
YES ❑ NO ❑
Business __ Speculation
Specifications for System:
`This permit Void if sewage system described below is not installed within 36 months from date of issue.
✓ Mr `r
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:
System Installed by _
t'
,
11
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.
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 14!' s e ! 'i -)p, , fi i y DATE sem- . :. . PERMIT
LOCATION t._ 919
�— �►} S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE [ MOBILE HOME ❑ BUSINESS ❑
16
'•,.-
House Trailer
800
Gal.
400 Sq. Ft.
N0. BEDROOMS N0. BATHROOMS
Two Bedroom House
800
Gal.
600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES El=N0 •-�"
Three Bedroom House
900
Gal.
900 Sq. Ft.
AUTO. DISHWASHER YES (Z.--- NO ❑
Four Bedroom House
1000
Gal.
1200 Sq. Ft.
AUTO. WASH. MACHINE YES Ci.: NO ❑
SITE SUITABLE YES Q3,�NO ❑�
x
SIZE OF TANK gal. t!>< f✓L,!"
NITRIFICATION FIELD` �./r ;` L' sq. ft.
DEPTH OF STONE IN LINES:t r
e
WATER SUPPLY: Individual sM--,-Piublic ❑
IMPROVEMENTS PERMIT BY
INSTALLED BY
,
CERTIFICATE OF COMPLETIONt1 , =,�
Date �n `! / (0
(8/16/73) *Construction must comply%with all other applicable State and local regulations
LOT AREA
! .s i �C► e' v,C .ice
vW?(
t�J
Cts
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 CONTRACTORs DATE t�, 4_A� PERMIT
"f N° 919
LOCATION%. �s, �' "�`••. 6r
- � S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME BUSINESS ❑
10 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 [ZI.'•NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES [;_L,,. NO ❑
SITE SUITABLE YES Q5, --'NO ❑1
SIZE OF TANK • ,r, gal. !17 j+✓`�
NITRIFICATION FIELD(: j �,;�;... sq. ft.
DEPTH OF STONE IN LINES:�
WATER SUPPLY: Individual Gl,-Piublic ❑
IMPROVEMENTS PERMIT BY ' , ,_ �i ; ' .. INSTALLED BY
CERTIFICATE OF COMPLETION`) �✓` �f `rte, f
By Date
(8/16/73) *Construction must compl�,with all other applicable State and local regulations
LOT AREA
t..- I /DG. v 73,
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