206 Murphy Rd (2) DAVIE COUNT( HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
1 / f Permit Number
Name ' ' '� .� /o,•�:'� Date
Location
Subdivision Name __ Lot No. Sec. or Block No.
Lot Size ��i'' House Mobile Home _t/ Business Speculation
No. Bedrooms -�� No. Baths !2 No. in Family
Garbage Disposal YES ❑ NO Q' Specifications for System:
Auto Dish Washer YES NO 0
Auto Wash Machine YES [f] NO ❑
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
---------------
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
�0
Certificate of Completion Date
*The signing of this certificate shall indicate that the system described above has been installed in compliance with
--.`he standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
sa isfactorily for any given period of time.
I
DAVIE COMITY HEALTH DEPART I IT
ENVIROMENTAL HEALTH SECTION
SOIL/SITE EVALUATIOI?
1?Atm �!�% �' ,'� !� DATE
.e
ADDRESS n `/
LOCATION
LOT SIZE
TOPOGRAPHY:
SOIL TE"ITURE: 0011S,
. SOIL STRUCTURE: OP 5 f
DEPTH--�o
RESTRICTIVE HORIZONS:/Y Ale-
PERCOLATION PATE: Presoak Mark & time Drop_ Time Pate/ iin. Inch
2.
3.
*CLASSIFICATI01?: ,
Suitao Provisionally Suitable Unsuitable
COMIEIUTS:
SAP?ITARIAN
SITE DIAGF"
0
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