702 Ollie Harkey Rd DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Nota Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name Date
Location - r` 1. ',
Subdivision Name Lot No. Sec. or Block No.
Lot Size I'f 1/: House Mobile Home r--- Business Speculation
No. Bedrooms No. Baths No. in Family
Garbage Disposal YES ❑ NO p Specifications for„System:
Auto Dish Washer YES ❑ NO []
Auto Wash Machine YES p' NO ❑ ,,
Type Water Supply ---
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
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11
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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
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Certificate of Completion4 ! Date All kv
*The signing of this certificate shall indicate that the system described abov s been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken ap a guarantee that the system will function
satisfactorily for any given period of time.
DAVIE COUFTY HEALTH DEPART171ENT
ENVIRONI.fENTAL HEALTH SECTION
=, SOIL/SITE. EVALUATIOI?
y
I?AI9E rf�� ���t�r�- DATE
ADDRE S S
LOCATIO:x
77
LOT SIZE
TOPOGRAPHY: f!
SOIL TEI�TURE: j ,`
SOIL STRUCTURE: ]Q
DEPTH:
RESTRICTIVE HORIZOFS:
PERCOLATION RATE: Presoak Hark & time I Drop Time Pate/Hin. Inch
1.
2. ,D 3'`31
***CLASSIFICATIOI?:
Suitable P atonally Suitable Unsuitable
COMMITS:
: —�
SANITARIAN
SITE DIAGRAM
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