123 Woodburn Place Lot 12Name
Lot Size Housey� Mobile Home
No. Bedrooms — No. Baths cn No. in Family.
Garbage Disposal YES ❑ NO ,—
Auto Dish Washer YESNO
Auto Wash Machine YES ig F-1 NO ❑
Type Water Supply
Sec. or Block No?
Business Speculation
Specifications for System:
*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
6
WCC,
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 _ Date :�–Z
'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
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE:
Issued in Compliance With Article 11 of G.S. Chapter 130a
Sanitary Sewage Systems?''/ //
�8 /C�J
Permit'
NLmber .,
5958
Name
�D,—' GU02/Y�a/✓ Date /e/�
N2
A✓.r��i
Location
—2rt24– v
—
Name
Lot Size Housey� Mobile Home
No. Bedrooms — No. Baths cn No. in Family.
Garbage Disposal YES ❑ NO ,—
Auto Dish Washer YESNO
Auto Wash Machine YES ig F-1 NO ❑
Type Water Supply
Sec. or Block No?
Business Speculation
Specifications for System:
*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
6
WCC,
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 _ Date :�–Z
'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.
a
ao DAVIE COUNTY HEALTH DEPARTMENT �a tv
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance With Article I I of G.S. Chapter 130a ! ��
S-aan'it�ary Sewage Systems �Dly/e Permit Number
Name —+� 4%Ii,7_,V 2�Gf�0a/�/fu�✓ Date t%�%�//Q�i No '5958
Location 1ZL_
Block No=
Lot Size r House' Mobile Home Business Speculation
No. Bedrooms SL— No. Baths c-2 No. in Family
:Garbage Disposal YES ❑ NO ,O— Specifications for System:
Auto Dish Washer x, ; YES � NO ❑
Auto Wash Machine YES NO ❑
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.
J
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:
- - . /U e rA)
System Installed by
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
i.
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
NameT%r .Tizv_X Date 2'27'SfS� F� 3465
Location
Subdivision Name CRf£.C'u,00p Lot 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 ❑
Sec. or Block No
Business
Specifications for System
/JO /'C 3 X 2 q i7
Speculation
/ffp4/ 2
S7ar'r
'This permit Void if sewage system described below is not installed within 36 months from date of issue.
Improvements permit
'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. 1
.
Final Installation Diagram:
System Installed by
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 betaken as a guarantee that the system will function
satisfactorily for any given period of time.
_ 6 DAVIE COUNTY HEALTH DEPARTMENT
r ' 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
.Nameai-Z2-f?'f2 2� StS� re
Date — 3465
Location
Subdivision Name
Lot No. 7z Sec. or Block No.
Lot Size
House ti-'�
Mobile Home _ Business Speculation
No. Bedrooms
No.
Baths
No. in Family
Garbage Disposal
YES
❑ NO ❑
Specifications for System:
Auto Dish Washer
YES
❑ NO p
Auto Wash Machine
YES
❑ NO ❑
�OC 3 Xzf STONE
Type Water Supply
4)u Avo->
*This permit Void if sewage system described below is not installed within 36 months from date of issue
'IF14
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
Certificate of Completion LL ""C�f r 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 Sews Di pal S stem - G.S. Chapter 330 -Article 13C)
OWNER OR CONTRACTOR_If 4 t�j, y oAj.5, , � /i' - DATE �1 �.+�1-77J�MRMjIIT �.+
LOCATION Aet kt-�b u d 15 a 4 j t*U 1 Imo...: . V b! I M 631
SUBDIVISION NAME
LOT NO. .. SECTION OR BLOCK NO.
nUUDG L&j— riVb1LL nUAL L! nu DLrmbJ U
-
_
�i�
House Trailer
800 Gal.
. 400 Sq. Ft.
N0. BEDROOMS NO'.' BATHROOMS
Two Bedroom House
800 Gal.
600 Sq. Ft.
CARBAGE,DISPOSAL UNIT YES ®""NO , ❑
Three Bedroom House
900 Gal.
900 Sq. Ft.
AUTO.-DISASHER YES ®-° -NO ❑
Four Bedroom House
1000 Gal.
1200 Sq. Ft.
AUTO. WASP MACHINE YES Cg-, `NO . ❑
SITE SUITABLE YES (g�-'NO ❑
SIZE OF TANK` Q gal. .
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY Individual Uolofublic ❑
./ 4
IMPROVEMENTS PERMIT BY
INSTALLED BY
CERTIFICATE OF COMPLETION
(8/16/73) *Construction must compl rith all
LOT AREA;
i
e-1:ft• ate s 1
applicable State and,Wcal regulations
(t{VA
f
Z�.j
�ttbie (i�uun#g �ettl#li �epttr#men#
iinb pume Pea['4 4enty
P. O. BOX 665
Poc(rsbille, �qorfh ([Larolina 27028
OFFICE OF THE DIRECTOR
Lomas -Nettleton
1530-B Martin Street
Winston Salem, NC 27103
Dear Sirs:
May 8, 1986
TELEPHONE
I7O41 634-5885
Re: On-site Sewage Treatment and Disposal
System, Lot 1112, Creekwood I, Davie Co.
As per your request theraforementioned site was visited by a
representative from this office on May 7, 1986. On the date of the
visit there was no visible evidence that the septic tank system was
not functioning properly: '
Please advise should this office be of further assistance con-
cerning this matter.
Sincerely,
kit 7
Jdj'/
9.1 Mando, R. S.
Director, Environmental Health
JM:sg