1903 Angell Rd (3) DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND ,CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name ��t"�y0
,ailLocation
b0 1 fi h+ l2 ., t11" %�,tJ G C,. j2 t.� pv!I C s S J ; .17,(lK 1
Subdivision Name !' Lot No. - Sec. or Block No
Lot Size f A .House Mobile Home Business Speculation
;,
No. Bedrooms- No. Baths f' No. in Family
Garbage Disposal Y,ES ❑ NO ❑ s
Specifications for System:
Auto Dish Washer. YES ❑ NO .❑
Auto Wash Machine YES NO
Type Water Supply" G�!£l c" 4,fX' os-. eni�. r s'
*This permit Void if, sewage system described below is not installed within 36 months from date of issue.
SYS-1 rt-.: SIIAttouJ
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Improvements permit by
r,
*Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 'P.M. on day of completion. Telephone Number: 704-634-5985.
d. f l.�C'S�
Final Installation Diagram: °{ System Installed by
L
17
Certificate of Completion Date
-*The signing of this certificate shall indicate that^-the system described above has.been installed in compliance with
the standards set forth in,the above regulation, but'shall in NO way be taken as a guarantee that the system will function
�5;,' factorily for any given period of time.
- ,.
DAVIE COUI?TY HEALTH DEPART 1ENT
EIIVIR01-71HEALTH SECTION
SOIL/SITE EVALUATIOV
I?AIMSCc,-f-Fy -geACK- N DATE OC:-%09&2 Z0 19 F(
ADDRESS RZ.t. Z
jywKsVlILL Z ) N C LOCATIOIN Al Ay"6F�
j
fzz>. .4 1. 3 0-rF GvA c-^ iEtcH7"
LOT SIZE A L
TOPOGRAPHY: s
SOIL TEI:TURE:
SOIL STRUCTURE: S
DEPTH:
RESTRICTIVE, HORIZONS:
PERCOLATION RATE: Presoak Bark & time D op Time Pate iiir.. Inch
1. fitJ4.s. iC 1E, �of Ire— w`/�
3. >V—,l aro
***CLASSIFICATI
°Suitable Provisionally Suitable Unsuitable
COIRIEITTS
SANITARIA11
SITE DIAGRAM
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