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P1582 Hwy 64Wn DAVIE COUNTY HEALTH DEPARTMENT (Septic Tank) Improvements Permit arA_ CerQficate of Completion (Gropnd Absorption Sewage Disposal S tin' � G.S. Chapter �30 Ar)!icle 13C) OWNER OR CONTRACTOR-"�i:�=i� DATE/�, r �/% PERMIT LOCATION C:% �i�� lc�C'.�� /'- ri S.R. NO. SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO. HOUSE Er MOBILE HOME ❑ BUSINESS ❑ NO. BEDROOMS .,j NO. BATHROOMS GARBAGE DISPOSAL UNIT YES ❑ NO ❑ AUTO. DISHWASHER YES ❑ �2t0 ❑ AUTO. WASH. MACHINE YES U-"" NO ❑ SITE SUITABLE YES ❑ NO ❑ SIZE OF TANK gal. NITRIFICATION FIELD sq. ft. DEPTH OF STONE IN LINES: WATER SUPPLY: Individual Public IMPROVEMENTS PERMIT BY 1582 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. INSTALLED BY CERTIFICATE OF COMPLETION By Date � (8/16/73) *Construction must comply with al other applicable State and local regulations LOT AREA f DAVIE COUNTY HEALTH DEPARTMENT (Septic Tank) Improvements Permit ano-eroficate of Completion ` (Ground Absorption Sewage Dispopal S ,stem�r- G.S. Chapter,1,130-Article 13C) OWNER OR CONTRACTOR t '- �.';' _Cc -j,: lC.�;°„�i�j DATE i"'f `% /� PERMIT ,. `. r..� 1582 LOCATION i :' %i .e ,' . �'% <<,`r:e i • S.R. NO. SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO. HOUSE MOBILE HOME BUSINESS ❑ -� House Trailer 800 Gal. 400 Sq. Ft. NO. BEDROOMS N0. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft. GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House 900 Gal. 900 Sq. Ft. AUTO. DISHWASHER YES (:3 N0 ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft. AUTO. WASH. MACHINE YES ® NO ❑ -r, -- SITE SUITABLE YES ❑ NO ❑ ,. SIZE OF TANK gal.iZ v C ,. NITRIFICATION FIELD sq. ft. �� , DEPTH OF STONE IN LINES: WATER SUPPLY: Individual ©''Public, IMPROVEMENTS PERMIT BY5�1 ; �.,��/.,lif _ INSTALLED BY 1�6�1 !' r CERTI GATE OF COMPLETION By_L//0— L:"— r *Construction must comply with al (8/16/73) LOT AREA Date 2X1,717 other applicable State and local regulations 1