617 Howardtown Circle 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 w, .
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size 1 & House Mobile Home _ t--�'f Business Speculation
No. Bedrooms No. Baths No. in Family
Garbage Disposal YES ❑ NO p'--� Specifications for System: 5C--0 < /77 Y �=
Auto Dish Washer YES ❑ NO ❑ SOD`,. a 12 J
Auto Wash Machine YES ❑ NO -❑ 7
Type Water Supply _
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
L�4/ ' IL
r
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
i
Or
Certificate of Completion Date r, /
*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 COUFTY HEALTH DEPART:IEITT
ENVIROFUEBTAL HEALTH SECTIOIT
SOIL/SITE EVALUATIOV
DATE ' c7
ADDRESS T Z (S 11Z
Zrs V,cc i: H C LOCATION 90L,)19 -V R t–
N 6zl:: S-
LOT SIZE ! A C -L7—&yL ( f
TOPOGRAPHY: 6v-zf 7 .
SOIL TEZTURE: WA-VL/ GLS(
, .
SOIL STRUCTURE: ye Z60
DEPTH.'—M?
RESTRICTIVE HORIZOITS:
PERCOLATION FATE: Presoak Hark. & time Drop Time Pate iiin. Inch
0w
1.
3.
***CLASSIFICATIOIT:Suitable Provisionally Suitable Unsuitable
COIj IETTTS:
Z o �
SAPTITARIATT
SITE DIAGF.AIMI
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7/ 10
DAVIE COUNTY, HEALTH DEPARTMENT"`.:" r
ENVIRONMENTAL_ HEALTH SECTION \
P.O. BOX 57
MOCKSVILLE; N.C. 27028
' (704). 634-5985
STATEI ENT FOR SEPTIC TA14K INTROVEMENTS PERMITS AND/OR SITE EVALUATIONS "V
NIUIE DATE
ADDRESS ell 7wo. PERMIT NO. 7--T
/Yl.ae- !`-f 1//f.t f- N C- o
7.
EXPLANATION OF CHARGE
AMOUNT DUE SANITARIAN
PLEASE REMIT THE ABOVE AMOUNT OF RECEIPT OF THIS STATEMENT.
*NOTICE: Evaluation(s) can not be completed until payment is received.
Irtmrovements Permits) can not be issued until payment is received.
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