112 Valley Oaks Drive Lot 2 D"IE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT ;AND ,CERTIFICATE OF COMPLETION
*Note: Issued. in Compliance with G.S. of North.Carolina;Chapter 130—Article1.36.7
Permit Num�jber
Name �', :, r r1elYM.CA (Y%0 y. i Date [a 2- �}4' 2F'�R411,
Location , 4a �,`n V": iI I4n'. ' ' st.. ;
Subdivision Name Lot No. Sec. or Block No.
Lot 'Size fi r�i YHousei M' Mobile Home — Business Speculation-
No. Bedrooms ,No. Baths No. in Family
Garbage Disposal YES .0 Nd
w, Auto Dish Washer , ? YES .ElNO Specifications for System: .9io(., fiaJ 7 ;
Auto Wash Machine YES Q NO
o��5 I Vo tit �0 ',Iw -
: Type Water .Supply t^n�,,,i ---
*This permit.Void if sewage system described below'is not installed within 36 months from date of issue.
h
4. r ifif
�
,
3 _
' - I i it -• � a: � -
t it
i Improvements permit by - i'� 1<_tA
*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 completio Telephone Number: 704-634-5985.
Final Installation Diagram: ji
Sys em Installed by
i�
I r
j,
;,
i + -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
ven
satisfactorily for any giperiod of time.
_u
! g
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
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 ❑ Specifications for System:
Auto Dish Washer YES ❑ NO ❑ ,
Auto Wash Machine YES ❑ NO ❑
Type Water Supply - __—
"This permit Void if sewage system described below is not installed within 36 months from date of issue.
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 '
j I
i
i
Certificate of Completion �- Date f
"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.
r r 1
DAVIE COUi?TY HEALTH DEPARTiIEITT
ENVI_ZOM-04TAL HEALTH SECTION
SOIL/SITE EVALUATION
I?AIS
DATE /- Z
ADDRESS -lc/
LOCATION /Z
LOT SIZE X/Fi
TOPOGRAPHY:
SOIL TE:.TURE s
e :
SOIL STRUCTURE as
DEPTH*._5*
RESTRICTIVE HORIZOFSo
PERCOLATION RATE: Presoak Bark & time Drop Time Fate/iiin. Inch
3 12
1J)"n 12')
3.
***CLASSIFICATIOI?s uitab a Provisionally Suitable Unsuitable
COIZ EI?TS e
SAP?ITARIAII .Una X41
SITE DIA^F-4-M
ry GL
4' t
lam.