1362 Ridge Rd 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 ,�. Y t P rU i Date
Location r, ;; _. t r.'',�,..,-C+_ _
Subdivision Name 7 Lot No. Sec. or Block No.
Lot Size `/ House Mobile Home _ Business Speculation
No. Bedrooms -? No. Baths No. in Family
Garbage Disposal YES ❑ NO S ecifications for System:
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Auto Dish Washer YES p- NO ❑ p y
Auto Wash Machine YES 0' NO ❑ ' - ,f. - `' =% x '`"s
Type Water Supply ;/_�� tt -- �' ",.c::t 'j .
"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
Cl
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Certificate of Completion �` \���t ' -� Date C� ' 1 '
"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
satisfactorily for any given period of time.
DAVIE COMMY HEALTH DEPARTN
PERCOLATION TEST RESULTS
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FIrIDINGS: HOLE 110. MMME ITS
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DAVIE COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SECTION
P. 0. BOX 57
MOCKSVILLE, N.C. 27028-
(704). 634-5985
7028(704) 634-5985
Statement for Septic Tank Improvements Permits and/or Site Evaluations
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ADDRESS___?A. U 3 PERMIT 140. 2f g.,
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EXPLANATION OF CHARGE ` '• ���.. �. $:'���►K 1�,��,�'
Atd0trn DUE O.UO 5At1ITARIAN
PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEMENT.
*NOTICE: Evaluation(s) can not be completed until pa1nent is received.
Improvements Permit(s) can not be issued until payment is received.