P2794 Hwy 801SDAVIE 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 f is S _ 1 - Date
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size I " ` `' House Mobile Home _ Business Speculation
No. Bedrooms No. Baths No. in Family
Garbage Disposal YES ❑ NO p` Specifications for System:
Auto Dish Washer YES ❑ NO
Auto Wash Machine YES Z" NO F]
Type Water Supplyr-
*This permit Void if sewage system -described below is not installed within' 36' months from date of issue.
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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-wr't�r�i��-
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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?ATS fiPn�v��
DAVIE COUPTY HEALTH DEPARTHEUT
ENVI_R,0141-MITAL HEALTH SECTION
SOIL/SITE EVALUATIOI?
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ADDRESS 2S7 /39ND 7a*
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ADvAce
DATE F- l-7-?/
LOCATION / .50u41�-
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0�&YLL Z S 2n cj <-t (-r-E Pc. ,vs z
LOT SIZE /,?,C)X �° �,,,
TOPOGRAPHY: G -60p
SOIL TE',,TURE : iZ,`G49 < < -"-d` L
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SOIL STRUCTURE",: IJYJ6• (Scoff %
DEPTH: 2
RESTRICTIVE HORIZOUS: /�c
PERCOLATION FATE:
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3.
Presoak
Mark & tine I
Drop
Time
Pate 11in. Inch
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***CLASSMCAT °Suitab el Provisionally Suitable Unsuitable
COT%EIITS
SITE DIAGMI
SAT?ITARIAN
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