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P1905 Ridge Rd
DAVIE COUNTY HEALTH DEPARTMENT *� (Septic Tank) Improvements Permit and Certificate of Completion HOME (Ground Absorption Sewa a Disposal System - G.S. Chapter 130 -Article 13C) OWNER OR CONTRACTOR��,i� lQ7, - DATE, = ,Y PERMIT LOCATION c_ tV - ii �/�. LL � VA N� 1905 _ �t s . .. , . _ �t.t NO ❑ ' YES S.R. NO. SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO. HOUSE p MOBILE HOME ©- -~' BUSINESS NO. BEDROOMS t, 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 Ek—Public ❑ IMPROVEMENTS PERMIT BY 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 R �C Date7T7k (8/16/73) *Construction must mply with all other applicable State and local "regula" tions LOT AREA i t i DAVIE COUNTY HEALTH DEPARTMENT P. 0. BOX 57 I40CKSVILLE, N. C. 27028 (704) 634-5985 Statement for Septic Tank Improvement Permits and/or Site Evaluations NAME r�4CR,, �-�.�ti DATE ISSUED�1/9fZF' —r ADDRESS 01 -,Witt PERMIT NO. %1CjCL. Explanation of charge /- AMOUNT DUE /.'&3 SANITARIAN \1• t — PLEASE REMIT THE ABOVE AHOUNT ON RECEIPT OF THIS STATEMENT.