1579 Underpass Road Lot 74~ 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 ;'.;, 1 DATE ,: PERMIT
•
} N° 1008
LOCATION
ii S.R. NO.
SUBDIVISION NAME j.l );: ::'�" 1 \', 1�', [` LOT NO. % SECTION OR BLOCK NO.
HOUSE ®" MOBILE HOME 0 BUSINESS
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES C9-- NO ❑
AUTO. WASH. MACHINE YES [D- NO ❑
SITE SUITABLE YES (E' NO ❑
SIZE OF TANK gal.
House Trailer
800
Gal.
400
Sq.
Ft.
Two Bedroom House
800
Gal.
600
Sq.
Ft.
Three Bedroom House
900
Gal.
900
Sq.
Ft.
Four Bedroom House
1000
Gal.
1200
Sq.
Ft.
NITRIFICATION FIELD sq. ft.
r
DEPTH OF STONE IN LINES: J�"/t"ur"l au zk moi' `` � y f/7 Po: of TA.v.,-'
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY \ `^' Y '� %;'- INSTALLED BY So S
CERTIFICATE OF COMPLETION 1�1\. If-, -A--� G _
(8/16/73)
LOT AREA
ByM- - Date
*Construction must c9-mply with all other applicable State and local regulations
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df . 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 , n g DATE PERMIT
LOCATION
Lim
N° . 1008
1
S. R. N0,
SUBDIVISION NAME JA ) Q5T R'Jq e , LOT NO. `7 SECTION OR BLOCK NO.
HOUSE GI" MOBILE HOME ❑ BUSINESS C
NO. BEDROOMS a NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES Qom' NO ❑
AUTO. WASH. MACHINE YES NO ❑
SITE SUITABLE YES NO ❑
SIZE OF TANK 0" gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES: / �A Uel w °-,- V.
WATER SUPPLY: Individual R'� Public ❑
IMPROVEMENTS PERMIT BY
CERTI
(8/16/73)
LOT AREA
TF OF COMPLETION
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. 600 Sq. Ft.
Three Bedroom House 900 Gal. 900 Sq. Ft.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
j q o a
INSTALLED BY
By Date
*Construction must comply with all other applicable State and local regulations
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