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149 McDaniel Road Lot 8DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number NameOintolIt,& t ti kfA11B Date 3`'-093' Location, Cot ,,T 7 Subdivision Name "ZZo&%Gw4RA Lot No. Q Sec. or Block No. Lot Size House Mobile Home _ Business Speculation No. Bedrooms 3 No. Baths I No. in Family Garbage Disposal YES I] NO I2 Specifications for System: j606 W_V_Ta4jL Auto Dish Washer YES [2-- NO ❑ —$'OX 20o"K 3"XI?Arm Auto Wash Machine YES p -'NO ❑ Type Water Supply cnfl *This permit Void if sewage system described below is not installed within 36 months from date of issue. Improvements permit *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 _�_ j— 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 COUNTY HEALTH DEPARTMENT Environmental Health Section P. 0. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION /l g DateG Lot Size Z61 2X8e AREA 3 AREA 4 FACTOPQ AGFA I ARFA 9 1) Topography/ Landscape Position S S S PS PS PS �S U U U >) Soil Texture (12-36 in.) Sandy, S S S S Loamy, Clayey, (note 2:1 Clay) 1:71US US US i) Soil Structure (12-36 in.) Clayey Soils S –Zep S PS S PS S PS �— U U U U I) Soil Depth (inches) © S S S PS PS PS PS U U U U i) Soil Drainage: Internal S S S S PS PS PS U U U U External S S PS S PS S PS U U U i) Restrictive Horizons `L6nP Available Space S S PS S PS S PS U U U U 1) Other (Specify) S PS S PS S PS S PS U U U U 1) Site Classification U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable Recommendations/Comments: Described by _ ,SITE DIAGRAM t A a.y .00 11 J