182 Main Church RdDAVIE COUNTY H DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR „l��P.S ��y; �(,' �� �S DATE J —L %- PERMIT
,, N9 197
LOCATI ON / r t �•i_ i!�L �_�.. / it " t i P . 'o X .3
_jeodro0iH Tn /J /d 6n s c, . f S. R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE
LE HOME ❑ BUSINESS
NO. BEDrR00MS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO
AUTO. DISHWASHER YES ❑ NO
AUTO. WASH. MACHINE YES P 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. , "'r�i
House Trailer
800 Gal.
400
Sq.
Ft.
Two Bedroom House
800.
600
Sq.
Ft.
Three Bedroom House00
Gal
900
Sq.
Ft.
Four Bedroom House
1000 Ga
1200
Sq.
Ft.
S- tamer's a f rS Sri f ]'/o ux's
INSTALLED BY ��p� 1 �,• i io rcc
CERTIFICATE OF COMPLETION By Date ' 7
(8/16/73) '*Construction must 4Lmply with all other applicable State and local regulations
LOT AREA �k � i /b% i '� ='' �� � , � �Z �r �U G•r Ct 4 C�tP
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Ae
)1,D 1-J'C
DAVIE COUNTY H DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
�. -Ground Absorption Sewage Disp-o'sar,^System (,-.S. Clapter 130 -Article 13C)
OWNER OR CONTRACTOR 111eZ kt* e. r4 m. Q,,1 DATE PERMIT (,�, �, . 2
N 00 197
LOCATION / i h,►�i i
SUBDIVISION NAME
LOT NO. SECTION OR BLOCK NO.
HOUSE q MOBILE HOME p BUSINESS p
NO. BEDROOMS 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 sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 8 600 Sq. Ft.
Three Bedroom House 900 Gal, 900 Sq. Ft.
Four Bedroom House 1000 Gal. 1200 Sq. Ft.
S- Pers ans 17-n Hoa -to
INSTALLED BY " Ot.% L,0':1)0 rd
CERTIFICATE OF COMPLETION By`ti rr '.;��„� Date 5 '-1 �' - /IV
(8/16/73) *Construction must Mmply with all other applicable State and local regulations
LOT AREA eta G � a,4 cl.