P2318 Howell 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
Name "� Date
Location
Subdivisiori Name Lot No. _ Sec. or Block No.
Lot Size ! - ' House Mobile Home _ Business Speculation
No. Bedrooms No. Baths No. in Family
Garbage Disposal YES 10 NO E] --
Specifications for System:
Auto Dish Washer YES p NO
Auto Wash Machine YES p NO p
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
r
/i'` �/ L. -I 'C
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
YVY //
1
Certificate of CompletionDate
*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
DAVIE COUZZ7 HEALTIi DEPARTMENT
PERCOLATION TEST RESULTS
DATE
NA.T:rE //
LOCA TIOLZ/ Ne� ,i Vll
FINDINGS: HOLE 140. COMMENTS
t
elwl
6
8y:2 � s
LOT DIAGRWI
t
A&/
DAVIE COUNTY HEALTH DEPARTMENT
P. 0. BOX 57
MOCKSVILLE, N. C. 27028
(7 04) 634-5985
Statement for Septic .Tank Improvement Permits
and orSit valuations
NAP�'E ,�'-�f /�/ J , DATE ISSUED
ADDRESSeY-4 PERMIT NO.
Explanation of charge
AMOUNT DUE to V SANITARIAN
PLEASE REMIT THE ABOVE A140UNT ON RECEIPT OF THIS STATEMENT.