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586 Hillcrest Dr :CTS 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 Co Cac7tc Tr:ai:;t: Date r.jIr,J72 1.41 8 Advc?n--c-- 13 acron on Iiiilcs` st: urvo aC.I a.—s from, Gr 'rC0.Location 1. Subdivision Name Lot No. Sec. or Block No. Lot Size 3 crcc House Mobile Home _ Business Speculation No. Bedrooms 3 No. Baths 1'= No. in Family Garbage Disposal YES p NO p" Specifications for System: Auto Dish Washer YES p-J NO Auto Wash Machine YES Q" NO Type Water Supply + i _— *This permit Void if sewage system described below is not installed within 36 months from date of issue. 50il/si t:c cvcal;.at ion tins good p L'Ut: Lhore aro a f eiJ lcu areas -that Mio £.cu j,3c SIS OLon roust: tic kop'Ll a°jny fro;: , syalt-cn uhouid be o11,311cu i:o a,llo;i for be ucrvicu Ivor t lic period of yearn. Contat—.b t:hl.� of-Fico if cny changoo ohould bo nccd'--, 1 on lnyoub, t.e-�¢ccl` cam'L� � _-, - �• / \t J 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 ti .. �M�� Certificate of Completion c\ 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 satisfactorily for any given,period of time. DAVIE COMMIT HEALTH DEPARTMENT PERCOLATION TEST RESULTS DATE 5 azg° p wood 7 �i� w-s, NAME LOCA.IOi1 FINDINGS: HOLE 130. COMMITS / n So: 8ai/,'/cs- L3y rte-r� / , �°� ` 5 C_ 6 By: LOT DIAGRAM I DAVIE COUNTY HEALTH DEPARTMENT P. 0. BOX 57 MOCKSVILLE, N. C. 27028 (704) 634-5985 Statement for Septic Tank Improvement Permits and/or Site Evaluations . NAME r' P.ngm Tr flhl- DATE ISSUED 5/15/79 ADDRESS )ao 0 Ker _� 4 �ti. PERMIT NO. 2140 C �Nw 2 70/2- Explanation of charge soillei'It© evaluation and coptica tank layout AMOUNT DUE .-gnnn SANITARIAN I•lando PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEMENT.