159 Parker Rd (2)DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
"Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Date
Location X-'
Permit Number
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 ❑ NO EE] Specifications for System:
Auto Dish Washer YES p' NO ❑
Auto Wash Machine YES ❑ NO
Type Water Supply __— [�
'This permit Void if sewage system described below is not installed within 36 months from date of issue.
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
i
i
Certificate of Completion ' ` '� I Date
1
'The signing of this certificate shall indicate that the -system-described-above -has-Ueen installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee thatAhe.system will function
satisfactorily for any given period of time.
DAVIE COUFTY HEALTH DEPARTi1ETTT
ENVIRONMERTAL HEALTH SECTION
SOIL/SITE EVALUATIOV
ITAI�
ADDRESS
DATE
LOCATIO1d
LOT SIZE
TOPOGRAPHY: / ,f
SOIL TE��TURE:
SOIL STRUCTURE:
DEPTH:
RESTRICTIVE HORIZOFS:
PERCOLATION PATE:
1.
2.
3.
Presoak Mark & time Drop Time Pate/hin. Inch
* CLASSIFICATIOPT:Suitable Provisionally Suitable Unsuitable
.. COMMITTS:
SAF ITARIAIT
SITE DIAGFAY1