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152 Valley Oaks Dr 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. Date Location Subdivision NameLot No. Sec. or Block No. Lot Size -7- House Mobile Home Business — Speculation No. Bedrooms No. Baths No. in Family Garbage Disposal YES 1E] NO F±] Specifications for System: Auto Dish Washer YES p NO ❑ �jrj Auto Wash Machine YES NO -F-1 Type Water Supply *This permit Void if sewage system described below is not installed within 36 months from date of issue. 'lee improvements permit by *Contact a representative of the Davie County 1;1ealth 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. L Final Installation Diagram: r- .-'System Installed by Certificate of Completion '% Date Date t "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 COUNTY'eHEALTH DEPARTMENT ? 0 ENVIRDII14EIlTAL HEALTH SECTIO14 5 P.O. BOX S7 MOCKSVILLE, N.C. 27028 r/ / (704) 634-5985 G,S STATEMENT FOR SEPTIC TANK IMPROVEMENTS PERMITS AND/OR SITE EVALPA IONS NAME DATE ADDRESS PERMIT NO.Vo 7 Z f IlAtJC E I C 7. -7" - �f SiT� �,J�Zun•f��,-.. / fn,..p��,,jJ�1,�rH-x-S EXPLANATION OF CHARGE 2 0 ," fit. A''`20UNT DUI; SANITARIA2 PLEASE REMIT THE ABOVE AMOUNT OF RECEIPT OF THIS STATEMENT. *NOTICE: Evaluation(s) can not be completed until payment is received. Irmrovements Permit(s) cannot be issued until payment is received. DAVIE COUNTY HEALTH DEPARTMENT PERCOLATION TEST RESULTS DATE S`r NAME 14 Pix 3 a Ap✓�a,�� 2� LOCATION ��kl� �l�' rc-Y l TOrlN //J 4a-E-`''J- -7c) tz tJ 16",r Msi 7— FINDINGS: —FINDINGS: HOLE NO. C01,24ENTS s - I. - lam ', 0 3 N r © . 2.,- r L �f � ll�� 10 14. S. 6. By: , LOT DIAGRA?.i f iJ