P1253 Angell RdA DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorp4 o Sewage Dis oral System - G.S. Chapter 13 icle 13C)
OWNER OR CONTRACTOR X204'"-1 DATE O ,,.r� - PERMIT
LOCATION".; N
SUBDIVISION NAME
S. R. NO.
LOT NO. SECTION OR BLOCK NO.
HOUSE M MOBILE HOME ❑ BUSINESS
NO. BED OOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES NO ❑
SITE SUITABLE YES NO ❑
SIZE OF TANK 91 gal.
NITRIFICATION FIELD- sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY !
CERTIFICATE OF COMPLETION
By fV
(8/16/73) *Construction must comp
LOT AREA
P
1253
House Trailer 800 ,Ga- 4.4D 10—zq,-y-t.
Two Bedroom House
Three Bedroom House 900 Gal. 900 Sq. Ft.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
INSTALLED BYyJ-AA-kO
>4— ✓ %. �'.. .-"-r,..g, ....y_ Date/ L —2- Y — /
with all other applicable State and local regulations
.A"4,
DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorp o Sewage Dis o al System - G.S. Chapter 13 ` icle 13C)
OWNER OR CONTRACTOR -� 0 -t" C� / .� DATE PERMIT
LOCATION N? 1253
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME E3 BUSINESS
NO. BED OOMS g3- NO. BATHROOMS L
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES [�] NO ❑
AUTO. WASH. MACHINE YES NO ❑
SITE SUITABLE YES NO ❑
SIZE OF TANK 190 45D gal.
NITRIFICATION FIELD : sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: IndividuAele
Public ❑
IMPROVEMENTS PERMIT BY
CERTIFICATE OF COMPLETION
By
(8/16/73) *Construction must comp
LOT AREA
House Trailer 80_0 -La -l-,
Two Bedroom House 4C Rnn_rqi
Three Bedroom House 900 Gal. 900 Sq. Ft.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
INSTALLED BY��
with all other applicable Sta
Date/
and local regulations
0