P2865 Legion Cemetery StDAVIE COUNTY HEALTH DEPARTMENT
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*Note: Issued in Compliance with,G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
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Location
Subdivision N&ne
Lot 8ba____
No. Bedrooms
GarbogeDiopc
Auto Dish Was
Auto Wash K4a
Type Water S
Lot No.
Son orBlock No
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House -' Mobile Home _-_-____ Business _______-Speculation
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*This permit V idifsewage system described ��|�w�i �mor�ohnmda���s�.
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Improvements permit by
*Contact a repHealth Department for final inspection of this system between 8:309:30 A.M. or 1:00-1:30 P.M. on day,of completion. Telephone Number: 704-634-5985.
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*The signing oi
the standards '
satisfactorily ft
Diagram:
System Installed by
Certificate mfCompletion /` �~-�� Oab*
this certificate shall indicate that the system described b has been installed in compliance with
forth in the above vegu|odion, but ahoU in NO way betaken as o guarantee that the system will function
�ony given period of time. _.- ^
MAIM
ADDRESS
DAVIE COUNTY HEALTH DEPARTIPENT
ENVIRONMENTAL HEALTH SECTION
SOIL/SITE EVALUATIOU
DATE
LOCATION �(
LOT SIZ �" /J�BU✓� /p�,—
TOPOG HY o
SOIL T • i,TURE e
SOIL S RUCTURE:/?0,e
DEPTH:
RESTRI TIVE HORIZOVS:
PERCOLATION
RATE: Presoak
1.
2.
3.
Idark & time I
Drop
Time
Rate rein. Inch
%*CLASIFICATIOI?'Suitable Provisionally Suitable Unsuitable
COMIEII S
SANITARIAIT
SITE D AGFM