P457 Underpass RdDAVIE COUNTY HEALTH,DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorpt o ewage pisp�o l� Svsstem - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTORoretr�.�.�•") YT. DATEC,�'�'j�f " PERMIT
LOCATION _ _ ' � S.S~ �/ t i r`*a1'r /'ems 5 ; /c i C/o
SUBDIVISION NAME
HOUSE ❑ MOBILE HOME BUSINESS
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT
YES ❑
NO
❑
AUTO.
DISHWASHER
YES JQ
NO
❑
AUTO.
WASH. MACHINE
YES 15t
NO
❑
SITE
SUITABLE
YES ❑
NO
❑
SIZE
OF TANK
gal.
NITRIFICATION FIELD
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual —pub'
IMPROVEMENTS PERMIT BY
LOT NO.
sq. ft.
CERTIFICATE OF COMPLETION By x
(8/16/73) *Construction must comply
LOT AREA
F07
S. R. NO.
SECTION OR BLOCK NO.
457
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.
a (16510
/ Y Q i /r rCrcr J �--
r
fare, 7�r,
INSTALLED BY
7
t'F
Date 'T /?- 7 �
th all other applicable State and local regulations
t
, .&
COUNTY OF DAVIE
CERTIFICATE OF ZONING COMPLIANCE
This is to certify that
have fully complied with the provisions of the Davie County
Zoning Ordinance in the proposed constructions, alterations,
additions, or uses of a building or other structure located
or to be located at: _5" ,Q _ 16-15-6
As Follows: _2 % X1'l
This tal Day of &/19 75
Davie County Zoning
Enforcement Officer
Phone: 634-3340
CERTIFICATE OF OCCUPANCY
This is to certify that the proposed constructions alter-
ations, additions, or used have been completed in comformity
to the Davie County Zoning Ordinance.
This Day of _�19 Z
Davie County Zoning
Enforcement Officer
Phone: 634-3340