P251 Edwards RdDAVIE COLTNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130-Article:13C)
OWNER OR CONTRACTOR 1 .'• ., _ <;,,A'% DATE .7 2': - 74! PERMIT
N° 251
LOCATIONt`
S.R. NO. /--u'ra
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ,E). MOBILE HOME ❑ BUSINESS
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NOQ
AUTO. DISHWASHER YES ( NO ❑
AUTO. WASH. MACHINE YES l NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK +"% gal.
NITRIFICATION FIELD �<f-0 sq. ft.
DEPTH OF STONE IN LINES:ryii
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY
House Trailer 800 Gal.
400 Sq. Ft.
Two Bedroom House 800
6- I -Sr} .-.-
Three Bedroom House 00
-100 ,SS , -F -t-?
Four Bedroom House 1000 Gal.
1200 Sq. Ft.
n (�
-Z'
INSTALLED BY •1,:C:. `.7r t
CERTIFICATE OF COMPLETION
By �C' ..•�i's.�•::t <.`_� Date �" "" .t�►'+ 741e
(8/16/73) *Construction must ply with all other applicable State and local regulations
LOT AREA
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7r
DAVIE COUNTY ' HEALTH DEPARTMENT
(Septic Tank) In Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR _dame irc cs_Y� cv�5 ~ ulrr.c ; �c�3 DATE q _,; - %� PERMIT
LOCATION��}��it,�C� — �orxr� 1� — �as l e S"tit ISS. lr�' 251
i n IP�`i'- �1i�a�r cl. 1�3s 11�T►� �L."i'. S.R. NO. /
SUBDIVISION NAME
HOUSE
BUSINESS
LOT NO. SECTION OR BLOCK NO.
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO KY
AUTO. DISHWASHER YES �' NO ❑
AUTO. WASH. MACHINE YES NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK 0� _ gal.
NITRIFICATION FIELD � sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual x Public ❑
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
6-4
�P—w ?e -r "�0+)
800 Gal. 400 Sq. Ft.
800 al. 600 t.
00 Gal 00 Sq. F
1000 Gal. 1200 Sq. Ft.
IMPROVEMENTS PERMIT BY `. �?- .-«fir, I INSTALLED BY —h &o r C-, 57T. (�O .
CERTIFICATE OF COMPLETION B, ae r, Date b
(8/16/73) *Construction must ctoply with all other applicable State and local regulations
LOT AREA :3 fit -Ra --5
6 /' - I ,
_
�� ) T X 1ilr�7�lle.