P265 Bethel Church RdDAVIE COUNTY HEALTH DEPARTMENT
` ti • (Septic Tank) Improvements Permit''and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR DATE - PERMIT
No 265
LOCATION
-- -- - -- v S.R. N0.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE Pq MOBILE HOME ❑ BUSINESS ❑
NO. BEDROOMS I NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD 411 sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual P Public ❑
r.
IMPROVEMENTS PERMIT BY` . ',. ,
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
4
'
800
Gal.
400
Sq.
Ft.
800
Gal.
600
Sq.
Ft.
900
Gal.
900
Sq.
Ft.
1000
Gal.
1200
Sq.
Ft.
INSTALLED BY '„ i'R., . ;,<_ w.`~. ",
CERTIFICATE OF COMPLETION
By ,� ,_ .::> .^� .�+ Date It' 14
(8/16/73) *Construction must 6g6ply with all other applicable State and local regulations
LOT AREA
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!'"Xp;11 j2aA". Ccs-%i`nr• FoXi DATE PERMIT
LOCATION C)1 �3 . C � �. - h -s t'� �Y, ; ' r .}.T i h ►k.::k Cod) N? 265
� S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE W MOBILE HOME BUSINESS ❑
NO. BEDROOMS I NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES
❑
NO
❑
AUTO.
DISHWASHER YES
❑
NO
❑
AUTO.
WASH. MACHINE YES
❑
NO
❑
SITE
SUITABLE YES
❑
NO
❑
SIZE
OF TANK � O gal.
1200
Sq.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES: &//
WATER SUPPLY: Individual A Public ❑
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.
IMPROVEMENTS PERMIT BY \ ,,��-z I INSTALLED BY
7 T
CERTIFICATE OF COMPLETION
BY- b�'7�
Date �"
(8/16/73) *Construction must mply with all other applicable State and local regulations
LOT AREA