P848 Main Church RdDAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground AbsorptioP Sewage�Disposal S s em - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR DATE
/( — PERMIT
r
LOCATION '~' r rte. N� 848
.�`f�:t� � � �..,�•/ � • ,•�
i' S. R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOME 0 BUSINESS
NO. BEDROOMS NO. BATHROOMS ;•
GARBAGE DISPOSAL UNIT YES ❑ 0
AUTO. DISHWASHER YES [ 0 t?l
AUTO. WASH. MACHINE YES �O ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD Q Qp sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual- Pu ElIMPROVEMENTS PERMIT BY � l La,c.�rr,
CERTIFICA
(8/16/73)
LOT ARE
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
TALLED BY
800 Gal. 400
Sq.
Ft.
800 Gal. 600
Sq.
Ft.
00
Sq.
Ft.
I000 Cal. 12200
Sq.
Ft.
K J F 1�b c k 21 J N' A
TE OF COMPLETION
BY Date
*Construction must comply with all other applicable State and local regulations
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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 DATE PERMIT
f. T
LOCATION -„• f t / .-i ._� �_. f r„ Sr' l� 8 4 8
1' S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME ❑ BUSINESS I
NO. BEDROOMS NO. BATHROOMS r
GARBAGE DISPOSAL UNIT YES ❑ }_
AUTO. DISHWASHER YES L4e,00
�'❑'
AUTO. WASH. MACHINE YES D" NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD ?I; sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑
� F
IMPROVEMENTS PERMIT BY(,li
f
House Trailer 800 Gal. 400 Sq. Ft,
Two Bedroom House 800 Gal. 600 Sq. Ft.
Three Bedroom House 900 Sq. Ft.
Four Bedroom House a 1200 Sq. Ft.
D BY
CERTIFICATE OF COMPLETION By Date
(8/16/73) *Construction must comply with all other applicable State and local regulations
LOT AREA 1
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