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130 Sonora Drive Lot 11w, DAVIE 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 Name �� %� ^f�� Date Location Subdivision Name Lot No. ,i' Sec. or Block No. Lot Size House Mobile Home �� Business Speculation No. Bedrooms No. Baths No. in Family Garbage Disposal YES ❑ NO Q-- 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. 1,7v i -,ale jt, v Sr 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 !� �LC�f! _ice 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. i It 1,7v i -,ale jt, v Sr 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 !� �LC�f! _ice 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. ,SPL 4� DAVIE COUNTY HEALTH DEPARTMENT Wf>DdU•��le Environmental Health Section P. O. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Name ° Date Address ��i /�� Lot Size FACTORS AREA 1 AREA 2 AREA 3 AREA 4 1) Topography/ Landscape Position 9) S S S S ® ( > PS PS �' U U 2) Soil Texture (12-36 in.) Sandy, S S S S Loamy, Clayey, (note 2:1 Clay) 0> � PS PS U U U U 3) Soil Structure (12-36 in.) S S S S Clayey Soils © PPS PS U U U 1) Soil Depth (inches) � S�.� �JJ S PS S PS U U U U i) Soil Drainage: Internal S S C � � PS PS U U U U External S S S �S (rte � `tt�T PS U PS U U i) Restrictive Horizons•�..-- r Available Space S S. S S PS PS PS PS U U U U I) Other (Specify) S S S S PS PS PS PS U U U U Site Classification � S, U—UNSUITABLE S—SUITABLE PS—Provisionally_Suitable Recommendations/Comments: Described by Title ,.�!�"' Date SITE DIAGRAM DCHD (6-82)