P3038 Beauchamp RdDAVIE 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
r
Name ,�� _%:: r ,f,, Date L t yy
Ci4.b-- C
Location (� / ro/!�c e
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 p NO p
Specifications for SystemicAuto
Dish Dish Washer
YES p_ NOD
_. _ �, r '"" ,'• ti-
Auto Wash Machine
YES E NO ❑
Type Water Supply
`This permit Void if sewage system described
below is not installed within 36 months from date of issue.
7/ k/ ? -_
5,17•
f d. 41 D
F—j
-._..
Improvements permit by
�a
`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 byS"Q''60�
l2 fa LL-
Lr�
Certificate of Completion�?�--"-1-- Date2
"The signing of this certificate shall indicate that the system describeld 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.
Vim-. . ' -"
DAVIE COUPTY HEALTH DEPART TEUT
ENVIRONHERTAL HEALTH SECTION
SOILJSITE EVALUATIOU
VAME -44Z&
ADDRESS &/le - y7
LOT SIZE
TOPOGRAPHY: S
SOIL TE„TURE: PS -S
SOIL STRJC-.0 a:PS-S
DEPTH: S
RESTRICTIVE HORIZONS: NoA e�
PERCOLATION RATE:
1.
2.
3.
DATE ”' 28 2 -
LOC AT 1014
LOCAT1014 C(AIta'EZt(t (-j _ T. IeFt
%f -
S4454 4 = Der/ dp 1/F//
Presoak Turk & time Dro Time Fate iiir.. Inch
�'� o� "� CLAS SIFICATIOT? :
Suitable �rovi�siona�llyuitable Unsuitable
COT MITTS :
SAVITARIAH -�2 1
SITE DIAGEAvi