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772 Will Boone Road Lot 1- 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 �u�,k,�,`t`' El �s bate d - °6 �1 �;`'>� 58 Location a Subdivision Name s r i� `�� s Lot No. d i Sec. or Block No. Lot Size S Y House Mobile', Home _ Business Speculation +s' No. Bedrooms 3- No. Baths -- No. in Family II 11 , Garbage Disposal YES .I� . NO. ©^'' Specifications for 900 ,Auto Dish'Washer YES Q' NO fl Auto Wash Machine YES NO ;Q ��• �S°,X ll . I Improvements permit��by "t - '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: 704-63,4-5985. I — Date ("– ` installed in compliance with that the system will function N DAVIE COUNTY HEALTH DEPARTMENT � PERCOLATION TEST RESULTS L DATE /a - 2/ - 8'6 NAME 5/e'G ota-IJ LOCATION Wu !/ foorue A.,, FINDINGS: HOLE NO. 2. 3. 4. S. 6. COIR ENTS 'lepso�L -' g�it" ,8,liw,v - $u6so:L - C�4J yellow a/ /0"". v4q P��'/'� ' p,4 N!<r ,*f zq(- s6",- M„05V114 clay - L/44j �a�jaJn yp�7� - add � " (/l/r) %!/L✓ st/!�!' BY: Ila// - S:oNxlt ->7no� LOT DIAGRAM �6 f- G JZ5,1 F 7% ISI �IOE�t R..a, �/ If 3�►� 12 L s�t�� l DAVIE COUTITY HEALTH DEPARTMENT W ENVIRONMENTAL HEALTH SECTION 2'0 IV' P. 0. BOX 57 MOCKSVILLE, N.C. 27028 (704) 634-5985 Statement for Septic Tank Improvements Permits and/or Site Evaluations NAME (' l DATE ADDRESS,*�. p !� .i�� PERMIT 140. 2),S q $ /Y�lf/f�c.•r�L EXPLA11ATION OF CHARGE S -''. �, w i! " T�� i p. .-► A120UiJT DUE /j��Od SANITARIAN !)1Ci,,r, - - - PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEMENT. *NOTICE: Evaluation(s) can not be completed until payment is received. Improvements Permit(s) can not be issued until payment is received.