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4421 Hwy 64W DAVIE COUNTY HEALTH DEPARTMENT R tiG IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION `Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c. Permit Number Name '"i`� l J':"': r= �'`✓,- Date" `� %�Y s'�. zl_ Location / r -_' ,fes. �r �r J l f• �� %.�Y;�.r l ��%,� Subdivision Name Lot No. Sec. or Block No. Lot Size � '�-'% House �� Mobile Home _�� Business Speculation No. Bedrooms No. Baths—./,A No. in Family Garbage Disposal YES p NO 4 Specifications for System: Auto Dish Washer YES p NO Auto Wash Machine YES p NO p Type Water Supply `This permit Void if sewage system described below is not installed within 36 months from date of issue. G- 7 - -2J - t�u.f�� la C r Improvements permit by r "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 Certificate of Completion T � ' !� r_ Date L "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. 1' ✓� f� ! DAVIE CQU TYrH ALT_H,ffrDEARTtdENT `", MQCKSVILLE , N. C .' 27028 / %i''° tee•_; r '�� ..(704) 634-5985 Statement for 'Septic Tank Improvement Permits and/or Site Evaluations NAME �r'/' C; ��/i!h/S67/L�' DATE ISSUED�1/ ADDRESSs fJ,� � PERMIT` NO . . .- 1 - Explanation, of charge ��,•�tr ��//�� , � r^`,YI�' or AMOUNT DUE Q, � j SANITARIAN PLEASE REMIT THE"ABOVE"'Ar>IOU'NT""ON'-115Ct rPTOF THIS STATEMENT.- M DAVIE COUNTY HEALTH DEPARTMENT PERCOLATION TEST RESULTS DATE c-5 l �� jC/ NAIME Ou 2/; LOCATIOi3 SiUP <c►�i H%S l.•�i G f'�C ��o,`!J7 FINDINGS: HOLE NO. COMMITS f 3 By: LOT DIAGRAM ' 1 pralth P pa r#men# n� 'um.e . 'Calth Astucv P. O. BOX 57 ' . •'. �Eluclsstlillc, �nr#1� (!lttrulicctt 27Qz8 OFFICE OF THE,DIRECTOR TELEPHONE 704/ 634.5985 May 25, 1979 Mr:. 6urlie Stevenson Route 1 , Box 339 p1ocksvil1.e, N.C.-27028 Re: Soil/Site Evaluation of,-Property Located on 'Ridge Road . Beside County Line Fire Department Mr. Stevenson: This past week arepresentative from this office visited the above mentioned location for the purpose of evaluating the property, for the instal?.ation of a conventional ground absorption sewage system. Upon arrival. on the property we found the perk holesq but no woter was left. for 'our staff to .complete the test.. We also could not determine where your .property lines wore:. I would urge you to reveiw the Information Aulletin that this office Dave to you. Once all the required. steps have been -taken, as stated in this bulletin, you should notify this office and we shall schedule for property to be evaluated. If you; have any question concerning this matter feel free to notify this office at your conveince. incoroly, o© MindoSanitarian Supervisor Davie County Health Department;