128 Pinebrook Dr y: DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note:Alssued incompliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name_ Date
Location
Subdivision Name Lot No. Sec. or Block No.
.,
Lot Size <` t:,' House Mobile Home — 'Business -- Speculation
No. Bedrooms No. Baths No. in Family
Garbage Disposal YES .0 NO E] ` Specifications for System: ;
Auto Dish Washer YES p NO p –
Auto Wash Machine YES p NO ,r-1
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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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: V ystem Installed by
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A0 �-
1An1Ye� Certificate of Completion Date
*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.
6
DAVIE COUNTY HEALTH DEPARTMENT
°f IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note:.4ssued.•in7"bompliance with G.S. of North Carolina Chapter 130—Article 13c.
--� - Permit Number
Name Date ~'•
Locationrr
'"i .�%�,.� �' ' : %,r' – ✓'` �.-�, r �'`� :: ;,-f �;
.�' i Jr''� J. %' �'• r moi" (<^ 1' (�% `-,\ J,'' ,.rir.� ,f' y/1.. _ .�� ..�..4',rf %:� ,. �/
Subdivision Name Lot No. Sec. or Block No.
Lot Size = f�-�' House -'� A Mobile Home _' Business Speculation
t
No. Bedrooms -� No. Baths �--'��' No. in Family
Garbage Disposal YES .l] NO ❑" Specificationsjor,System: ,f f
Auto Dish Washer YES p NO p
Auto Wash Machine YESNO C]
Type Water Supply �r '��
I�r
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
L—--------------------
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: L,System Installed by
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1ait1�� f 'Certificate of Completion
.., �� Date
*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. COMITY HEALTH DEPARMIENT
PERCOLATION TEST RESULTS
DATE
NA.T'lE �.r���lJ 5g%&
LOCATION
FINDINGS: HOLE 110. CODiMENTS
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DAVIE COUNTY HEALTH DEPARTMENT
i� P. 0. BOX 57
MOCKSVILLE, N. C . 27028
(704) 634-5985
Statement for Septic Tank Improvement Permits
and/or Site Evaluations
APS; � -- '`1 DATE ISSUED ,
ADDRESS PERMIT NO.
Explanation of charge
1
AMOUNT DUE CD SANITARIAN
Co►
PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEMENT.
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P. O. BOX 57
A366tialej NP011 (gni r0It'ua 27028
OFFICE OF THE DIRECTORTELEPHONE
April 14j 1980 704/634.6886
Tommy Anthony
Village Builders
Box 173
Clemmonsj N.C. 27012
Re: Franklin Woods Sewage Disposal System
Dear Mr. Anthony:
+
On April 11, 1980 at approximately 11;30 a.m. this, office conducted
an inspection of the Septic Tank System that was installed by Well
.:Drillers inc.. at the Franklin Woods residence on Pineboork Drive in
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Davie - 'County N.C.
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At that time''checkng the grade on the trenches with a transi
this office determined-that all the lines had excess fall on -them;, th'e'
later 4 lines had from 16" to 28" fall in thein: State Regulations allow
for 2 1/2" fall. every 100' . After determining the fall, the Septic Tank
Contractor was told to correct the grade problem and call this office for
a reinspection. No call was received on the afternoon of April 11, 1980.
On April 14, 1980 at approximately 2:30 p.m. this office returned :to
said,site.to survey the situation. At that time it was noted that the
enti.re' system was flooded and water .had pooled In :tlie last 10=501 :of 4
lines. it stands to reason; through these observations that the bottoms
of the trenches are also off grade.
Due to the above stated deficiencies in this Septic Tank System,this
office is condemning this installation and a new system must be installed
that meets previous_specifications.
. If you`haVe any .questions concerning this matter; feel free to call:
Sincerely,
Robert B. Hall, Jr. , Sanitarian
Davie Co.Ilealth Dept:
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P.O. BOX 57 F'rxi t
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OFFICE OF THE DIRECTOR
:! i Apri1 21P 1980 TELEPHONE r
p+ 7041 1944 69196
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Tommy Anthony
h Village Builders fr, r 4k
Box 173
s '
Clemmons, N.C:
Re: Franklin Woods Sewage Disposal 'System . Vit,`
Dbar:Mr. Anthony: n,y
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.t On April 18, 1980 this office met with Mr. Clayton of Well
Drillers Inc. at the Franklin Woods home on Pine'brook Drive in r:
Davie County. At that time a revised layout was issued which k
includes the lines shown on the previous layout as- well as two others,. }
equally 200 :x 3 x 12". With the addition of these extra lines, the '
t i previously installed system can be salvaged: , . `�
°Mt} If you have any- questions concerning this matter, feel free to
call. " €
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Sincerely yours,, fir:
41
Robert .B: Hall, Jr: Sanitarian �s
Davie County Health Department
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