979 Peoples Creek Rd (2) `
DAVIE COUNTY HEALTH DEPARTMENT
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- . IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.G. of NorthCarolina (�hapUsr13O--ArUc|a13c. '
Permit Number
Name _____ Dota
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Location
Subdivision Name Lot No. Sec. or Block No
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Lot 8ioa � � ^ / ~ House —~— Business —_—__ Speculation
--___—__-
No. Bedrooms No. Baths No. in Family
Garbage Disposal YES ;E] NO 0' Specifications for System:
Auto Dish Washer YES []^ NO
Auto Wash Machine YES . NO �E]
Type Water Supply /^I '
*This permit Void if sewage system described below is not installed within 36 months from dabs of issue.
Improvements permit
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*Contact o representative of the Davie Couhtv Health Department for final inspection of this oyob»m between 8:30-
9:30 A.M.
<]O'9:3OA.M. or 1:00-1:30 P.M. on day of completion. Telephone Number: TD4'G34-5SB5.
Final Installation Diagram: Systern Installed by f�4. Z--101
Certificate of Completion Date
'The signing of this certificate shall indicate that the system d hb~'� above has been installed in compliance with
the standardsaotfnrthinVheaboveregu|abon. budohollinNOwaybebakenaoaguarantoethottheoyatemviUfunodon
satisfactorily for any given period of time.
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`M DAVIE COUPITY HEALTH DEPAP.T IEITT
ENVI30111-1ENTAL HEALTH SECTION
SOIL/SITE EVALUATIO11
1?AIE IIS Lf JAU(ZS q9 k- 11/7Z DATE [ — /3 r Q' 2-
ADDRESS ZADDRESS
jADVAWC-f. Nc- -CATIO-4 � cd'ZS G/Z££K
LOT SIZE Tz)r I0 - tZ �` �s''�WN sir y
TOPOGRAPHY: L:
/ZED SATf6Y CC-"
SOIL TEZTURE: ( K c-C41
- 'SOIL STRUCTURE:
c(
J DEPTH:
RESTRICTIVE HOPLIZOVS {
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PERCOLATION PATE: Presoal, Hark & time DropTime Pate iiin. Inch
2.
3. 0" (7
***CLASSIFICATIOI?:Suitable Ptovisionally Suitable Unsuitable
COTiEI1TS
SANITARIAN
SITE DIAGFAY1
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