121 Martin Ln -_—__
. DAVIE COUNTY HEALTH DEPARTMENT
. � ' IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
°Nob»: Issued inCompliance with G.S. ofNorth Carolina Chapter13D--Adiu|e1On.
Permit Number
Name
Date
Locat
Subdivision Name Lot No. Soo or Block No
Lot Size House Mobile Home Business Speculation
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No. Bedrooms __—_---_' No. Baths ---_—__-_. No. in Fami|y—_�>—_---
Garbage Disposal YES r] NO F]^'
/\uto Dish Washer YES [] NO F]~- Specifications for System:
'
Auto Wash Machine YES 2-" NO F-1
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 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
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Certificate of Completion Dubs /
'The signing of this certificate ohoU indicate that the system described abowa 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.
DAVIE COUITTY HEALTH DEPART.-MIT
ENVIRON3ENTAL HEALTH SECTION
SOIL/SITE EVALUATIOV
VAIN ,r�ivn.��i /l��,eT:is+ 99'" F Y fe/'i►►• DATE
ADDRE S 5 7 f,C
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iv-e. 27oa1. LOCATION �ed .44A eW.4,Y-'
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LOT SIZE I '/2 6tC es
TOPOGRAPHY: Su:s 411,G
SOIL TE,,.TURE: IX.r2
SOIL STRUCTURE: 1;01,,e .-,,0ode- 6e ne a/ n4oxliw �tp✓�' y'✓ar�•c C/oy a� -�'•�'- 3�'��
DEPTH: ,r.Q%,2
RESTRICTIVE HORIZOFS: h/o o,4o•`o4wcCr yo pol p okL - rrloelef..
PERCOLATION PATE: Presoak Hark & time I Drop Time Pate/iiin. Inch
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b,49 2• d o.3d "61) G o
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CLASSIFICATIOIT:Suitable
rovisionally Suitable Unsuitable
COT2,-IEITTS: i-o �/ae�'' �!-�,..4• . f�re., �c�:lc� /�dNf t
SANITARIAI'Tltn,.lr a
SITE DIAGFAM v
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