P1375 Pine Ridge Rd(S tic Tank)
(Ground A orption Sei
OWNER OR CONTRAC M ja r N
LOCATION P ( n e k 9,t
OUNTY HEALTH DEPARTMENT
prove nts Permit and Certificate of Completion
e nal System - G.S. Chapter 130 -Article 13C)
..ter DATE �Z _7 PERMIT
N° 13"75
S. R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE P MOBILE
HOME RW BUSINESS ❑
NO. BEDROOMS 2
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
4000 sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BY
(5164- .
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.
�3qL% "Er
F� �ra�ie� To
INSTALLED BY a'tel`
CERTIFICATE OF COMPLETION By !�f& yy\dm[ O Date 0,12-5-177
(8/16/73) *Construction must c�mply with all other applicable State and local regulations
LOT AREA
�0 i QA,
_
all Aa�
t DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Di))sposallSystem - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR ArN_DATE ,Z %'% PERMIT
LOCATION P i n e kAx RJ' N? 1375
SUBDIVISION NAME
S. R. NO.
LOT NO. SECTION OR BLOCK NO.
HOUSE P MOBILE HOME IN BUSINESS
NO. BEDROOMS 2 NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES [3NO ❑
Q
SIZE OF TANK 6o gal.
NITRIFICATION FIELD 400 sq. ft.
DEPTH OF STONE IN LINES: tas, 1#vs4
WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BY q &t
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 L
CERTIFICATE OF COMPLETION By��a Dates%s`�7%/
(8/16/73) *Construction must c mply with all other applicable State and local regulations
LOT AREA
02atX-?,x/f.5-
7o2P