734 Bear Creek Church 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 t1 1; ., Date
4 �
f
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home Business Speculation
No. Bedrooms No. Baths No. in Family _
Garbage Disposal YES ❑ NO p Specifications for System: ?,,-
Auto Dish Washer YES ❑ NO p
Auto Wash Machine YES ❑ NO ❑ t
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
. e.
� I
i
i
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
'f
Certificate of Date
Completion �` �'
p ' ,
*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 HEALTH DEPAR-11.1 IEIdT
EIIVIROI-IMNTAL HEALTH SECTION
SOIL/SITE, EVALUATIOU
DATE
ADDRESS
/J7o�,�-�:/�� ��fi•l Z7o2� LOCATIO14
LOT SIZE 41d az, a
TOPOGRAPHY:
SOIL TE`.'TURE: tops.%L- to — 4s" &rte.►- �oa..� - 5kbso•l- SC•5l.}`, \�,�z o_� ���
ac.ov d, ,
SOIL STRUCTURE:
DEPTH:
RESTRICTIVE HORIZOIIS B ^ho v �n 1� ` — 5�.��'� � fQ .SAP
PERCOLATION RATE: Presoak Bark & time Drop Time Pate iiin. Inch
1
- 51' . b"
2. 12" q�5>
3.
***CLASSIFICATIOI?S
Suitable Provisionally Suitable Unsuitable
COMMEUTS E S C- Class• S rvV . S� � ��-t.�. t
SANITARIAN
SITE DIAGF"
_yl