462 Comanche Dr DAVIE COUNTY HEALTH DEPARTMENT a
r _ IMPROVEMENTS ;PERMIT AND CERTIFICATE OF COMPLETION
*Note��lsgued in Compliance with G.S. of North Carolina Chapter 130—Article 13c. I
Permit 'Number
Name �'" �� �✓ Date
Location' '�.�Z,r}J�• /
Subdivision Nam� 'i � -` �/ I� Lot No. Sec. or Block No.
Lot Size Houser Mobile Holme Business Speculation
No. Bedrooms No. Baths No. in Family
Garbage Disposal YES NO ��""� Specificatio s f r System: ti
Auto Dish Washer 'YES NO ❑ .
Auto Wash Machine ,Y}.ES�/ NOoe
Type-Water.Supply.
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
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Improvements permit b '� '
*Contact a representative of the Davie County Health DepNartment for final inspection of -this system between 8:30-
9:30 A.M. or 1:00-1.:30 P.M. -on- day of-completion. Tel Nphone Number: 704-634-5985. ,
Final Installation Diagram ystem Installed by�C 1j�� G � �i
:Certificate of Completion . Date
1 j
*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 guaranteelhat.-the system will function.
-satisfactorily for any given period of time. ,.
_ 1
DAVIE COUNTY HEALTH DEPARTMENT
PERCOLATION TEST RESULTS
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LOCATION-
4111'r161
OCATIOiJ4r
FINDINGS: HOLE 140. C011M 3TS
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By:
LOT '�G�S O,
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DAVIE COUNTY HEALTH DEPARTMENT
P. 0. BOX 57
MOCKSVILLE, N. C . 27028
(704) 634-5985
Statement for Septic Tank Improvemeg `it '
and/or Site Evaluations
NAMEDATE ISSUEDP�4j�t?
04vzel�l—
ADDRES `/P,x PERMIT NO.
Explanation of charge f
AMOUNT DUE SANITARIAN
PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEMENT.