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P2026 Howardtown Rd
r - DAVIE�;COUNTY ,HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION_ - *Note',Issued in Compliance with'G.S. of tNorth Carolina Chapter 130—Article 13c. Permit Number Name �, f. 1 Date L�. /. ?C '� ��'' 3J2Sb ` Location" c�N P ` - - Subdivision Name Lot No. Sec. or Block No. Lot Size House< Mobile Home _ Business__ Speculation S� No. Baths ! No. in Family ' No. Bedrooms - Garbage Disposal YES © NO ❑!; Specifications for System: .?Wx,, y Auto Dish Washer YES NO ❑j: f �j, } I 1D101�6.�✓'� Auto Wash Machine YES b NO. ❑� �/ ? -Type Water Supply t *This-permit Void if sewage system described below is not installed within 36 months from date of issue. } I, 1 �. Improvements permit by *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. - Final Installation Diagram: , System Installed by ?f N CA l ' { .3 3 2 r , Certificate of Completi n Date _ *The signing of this certificate shall.indicate that the system d scribed agove 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 satisfactorily for any given period of time. . _ i DAVIE COUNTY HEALTH DEPARTMENT �-• h'`�fnr P. 0. BOX 57 MOCKSVILLE, N. C. 27028 ,�/•� (704) 634-5985 �� I Statement for Septic Tank Improvement Permits and/or Site Evaluations NAME 1p,',V t DATE ISSUED ADDRESS ✓, �� ;Y�;`,� '''/2' 1"' PERMIT NO. dw �/, f�?�c-moi✓ .��-�.�7'I c^•� %�/��- Explanation ofp charge/S`, "/G t�'!1 f �� ✓' �fifl� AMOUNT DU LSANITARIANS/ PLEASE RE14IT THE ABOVE, AMOUNT ON RECEIPT OF THIS- STATEMENT... i DAVIE COUZ, HEALTH DEPARTMiT. PERCOLATION TEST RESULTS DATE LOCATION FINDINGS: HOLE NO. COMMENTS 1 42 42 3 A zz;q2- --4"t-v, 5 6 By: LOT DIAGRAM M M, �