P1336 Hwy 801SDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Dis{osal System - G.S. Chapter 30 -Article 13C)
OWNER OR CONTRACTOR DATE 2�^-VPERMIT
LOCATION - +�� �r��.!na.ce !��._,• 1 +! ` 4' 51 C!r;aG 40 lr? 1336
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
CERTIFICATE OF COMPLETION
BY—
(8/16/73) *Construction must
LOT AREA
"-A Date 3 .a 7
ly with all other applicable State and local egulations
a -- old Pr f �, ,#4 Priloc J,
"
House Trailer
800 Gal.
400 Sq. Ft.
NO. BEDROOMS D..
NO.
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
❑
NO ['r,
Four Bedroom House
1000 Gal.
1200 Sq. Ft.
AUTO. WASH. MACHINE
YES
L(
NO ❑
�' L�s�r "" , �..
SITE SUITABLE �y
YES
❑
NO ❑
SIZE OF TANK
gal.
NITRIFICATION FIELD
sq. ft.
- ,,,,t.. �1�c'Peo....A'
DEPTH OF STONE IN LINES:51
WATER SUPPLY: Individual
Public ❑
w�r.�
Pallet t`- v,
IMPROVEMENTS PERMIT BY
crt_ 1v
INSTALLED BY
CERTIFICATE OF COMPLETION
BY—
(8/16/73) *Construction must
LOT AREA
"-A Date 3 .a 7
ly with all other applicable State and local egulations
a -- old Pr f �, ,#4 Priloc J,
w DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Dis osal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR S f}r.,�,,,��, Sre;, i DATE 3 D-1•7'7 PERMIT
' �
LOCATION ''0l ���1aMee. 1t�.,,,� . IJs/ 1` es-�- �r;�e -{�, 14- N?
SUBDIVISION NAME
HOUSE
BUSINESS
S. R. NO.
LOT NO. SECTION OR BLOCK NO.
1336
CERTIFICATE OF COMPLETION By_ ( -
Date
(8/16/73) *Construction must c mply with all other applicable State and local egulations
LOT AREA
old ?6,,,:4 lk-+tnc�
I
House Trailer 800 Gal.
400 Sq. Ft.
N0. BEDROOMS 2
NO.
BATHROOMS
Two Bedroom House 800 Gal.
600 Sq. Ft.
GARBAGE DISPOSAL UNIT
YES
❑ NO 2—
Three Bedroom House 900 Gal.
900 Sq. Ft.
AUTO. DISHWASHER
YES
❑ NO Q'
Four Bedroom House 1000 Gal.
1200 Sq. Ft.
AUTO. WASH. MACHINE
YES
ET- NO ❑
S � �'^�'"`� ► SS u � di �,rrv.,� _
5�3o�7y�
SITE SUITABLE �y
SIZE OF TANK
YES [3 NO [3��
gal.
TNN,. 11. i1
NITRIFICATION FIELD
sq. ft.
,me- _ (dew ? �S`'u��
DEPTH OF STONE IN LINES:
< r,
51me. drd'-�:nC
�°`�( 6,+. ag
WATER SUPPLY: Individual
Public ❑
waS inS+,1enY
u,Qg octl( Q Fes-
IMPROVEMENTS PERMIT BY
INSTALLED BY Lu, Sco
CERTIFICATE OF COMPLETION By_ ( -
Date
(8/16/73) *Construction must c mply with all other applicable State and local egulations
LOT AREA
old ?6,,,:4 lk-+tnc�