117 W Robin Drive Lot 200 XD
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance With Article II of G. S. Chapter 130a
n/itary Sewage Systems Permit Number
Name i?�1�(1–c/rtJ�/lY �%ct //�✓ Date NO v I
,-
Location /��_ `/l� '/.��L 'Pbv l� ✓ ,n Yc Z'— Y -e
Subdivision Name W4°e1%c Lot No. o�- __ Sec. or Block No. y
Lot Size House Mobile Home _T Business _— Speculation
-t
No. Bedrooms. -,T .No. Baths _Q_ No. in Family__
Garbage Disposal YES ❑ NO p– Specifications for System:
Auto Dish Washer YES NO ❑
Auto Wash Ma shine YES NO ❑ ��v X oc?'
Type Water Supply
*This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
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
3Xx`V`
P
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.
00
DAVIE COUNTY HEALTH DEPARTMENT
FF :. IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
};6
*NOTE: Issued in Compliance With Article I I of G.S. Chapter 130a
Sanitary Sewage Systems Permit Number
Name iiliii-'i/,oS' �✓%% Date. NO'
Location L%
Subdivision Name ��010 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 p''li-Specifications for System:
Auto Dish Washer YES NO E- .
Auto Wash Ma^hine YES j NO ❑
\\J
Type Water Supply
*This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
i.- •
JJ;'�Id
i
1
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
Certificate of Completion��'�} �% Dates
r
'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:. \ , 3 DATE _ PERMIT
`531
LOCATION _�� • ..: ; _ ; ^ NO
` S.R. NO.
SUBDIVISION NAME \.qac:c���� -3` ""'�f�. LOT N0. SECTION OR BLOCK NO.
HOUSE
BUSINESS
NO. BEDROOMS 0 1 NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ 0
SIZE OF TANK gal.
NITRIFICATION FIELD Y 'S'i sq. ft.
DEPTH OF STONE IN LINES: % of
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY
CERTIFICATE OF COMPLETION By /r"(
(8/16/73) *Construction must comp
LOT AREA
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal,_ 600Sq.w...Ft.
Three Bedroom House e--900 Gal. x-2-00 Sq.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
INSTALLED BY // );�? 9 ' 7 ,, (2 /(,,,,/ ,
/ (.J Date (� — !4 ! V
with all other applicable State and local regulations
o MQ .3, 191