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P3244 Beauchamp Rd
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 �r1L'JrJ rtt/ufti 1��Z Date ��-Z - k3 ► ?32414 Location �,�r n �,[ i t �, .. f� i=' J( %�� s� r:. gun+ , j� `ti' L.s /i l %` 171 /N Subdivision Name Lot No. Sec. or Block No. Lot Size House '� Mobile Home _ Business Speculation No. Bedrooms -3 No. Baths Garbage Disposal YES ❑ NO Auto Dish Washer YESNO ❑ Auto Wash Machine YES g NO ❑ Type Water Supply W f ( L. No. in Family-- Specifications amily _ Specifications for System: /Ooo r � � �r c1 3DO �x? f ' / �N *This permit Void if sewage system es ribed below is not installed within 36 months from date of issue. 0 L�NCS i 0 if i j0 oy F e'2.t1(2 (Z T`i L.,N� i Improvements permit by -:�if- *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 bye DANS?�' �14 Certificate of C0mpletio,�` %'G.•- Date _ *The signing of this certificate shall indicate that the system descri ed above has been installed in compliance with the standards set forth in the above regulation, but shall in NO waybe taken as a guarantee that the system will function satisfactorily for any given period of time. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section R O. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Name S�AY�otl �OfZtJfiT�>r,R� ArlrlrPcc FACTOPR AREA 1 AREA 2 Date Lot Size AREA 3 AREA 4 Topography/ Landscape Position S S PS PS PS PS U U U U '.) Soil Texture (12-36 in.) Sandy, S S S S Loamy, Clayey, (note 2:1 Clay) (a) PS PS U 0 l7 U U 1) Soil Structure (12-36 in.) P S PS S PS Clayey Soils P U U U U 1) Soil Depth (inches) ® It S S PS PS PS PS U U U U Soil Drainage: Internal ^ Q S S `ISS PS PS PS U U U U External© Y S S PS PS PS U U U U i) Restrictive Horizons Available Space S PS 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 Cnnnmmcnri�#inns /r`nmmnn#�• Described by SITE DIAGRA f DCHD (6-82) S—SUITABLE ( PS—Fkovisionaliy Suitable Title Lo 400 3f'