159 Woodlee Drive Lot 7-8DAVIE COUNTY HEALTH DEPARTMENT '
' IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
`Note: Issued in Compliance with-G.S. of North Carolina. Chapter 130=Article 13c;
Perrriit :Number
Name �; �,+ ` P,�, °� Date
-
Location A
Subdivision Name Lot No. 7-a Sec. or Block .No. 3
Lot' Size House Mobile Home _ Business — Speculation
No. Bedrooms No. Baths —,No. in Family
Garbage Disposal YES ❑ NO_ ®
,.Specifications for System: ft
Auto Dish Washer YES ❑ NO , a ' .*3r
Auto Wash 'Machine YES E]NO
Type. Water 'Supply
*.This permit Void if sewage system described below is not installed within 36 months from date of issue.
. f t
. .�, - ,,6% -•;^pro .a.�'/lf�'�',
„
' 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..lnstallation Diagram: - System Installed, by e"
Certificate of Completion Date
#The signing of this certificate shall indicate that the system describe above has been installed incompliance with
the standard's 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 C.S..,Chapter 130 -Article 13C)
OWNER OR CONTRACTOR (J"'� Jl� PERMIT
LOCATION N? 1940
S.R. NO,
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO. .3
HOUSE [Ir MOBILE HOME 0
BUSINESS [3
House Trailer 800 Gal.
400
Sq.
Ft.
NO. BEDROOMS NO. BATHROOMS
Two Bedroom House 800 Gal.
600
Sq.
Ft.
GARBAGE DISPOSAL UNIT YES [3
NO 0
Three Bedroom House 900 Gal.
900
Sq.
Ft.
AUTO. DISHWASHER YES [3
NO ❑
Four Bedroom House 1000 Gal.
1200
Sq.
Ft.
AUTO. WASH. MACHINE YES [3
NO [3
SITE SUITABLE YES [3
NO E3
SIZE OF TANK gal.
NITRIFICATION FIELD
sq. ft.
DEPTH OF STONE IN LINES:
= Y ek .3 'x -Q4 41 -
WATER SUPPLY: Individual 0
iu C 9
1/-,
IMPROVEMENTS PERMIT BY
INSTALLED BY
CERTIFICATE OF COMPLETION
By
Date
(8/16/73) *Construction must
comply with a 1
/
Vother applicable State and local
reg 6lat�ions
LOT AREA
�J
49
DAVIE COUNTY HEALTH DEPARTMENT �(
V �'
P. 0. BOX 57 �i`�� �o,i�
MOCKSVILLE, N. C. 27028 lU
(704) 634-5985
Statement for Septic Tank Improve:lnent Permits
and/or Site EvaluationsI��1Ky j
NAME DATE ISSUED
ADDRESS P.4 PERMIT NO. �—
�, 42:UZ4 a 2l� --
Explanation of charge
AMOUNT DUE . SANITARIAN
PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STAMIENT.
r
DAVID.', COMM HEALTH DEPARTDIENT
P=OLATION TEST RESULTS
DATE
NA.^tiE
LOCATION
FINDINGS: HOLE 1.40. =D✓iMM
2
�
5
6
By : %
LOT DIAGIM
7,.