P3043 John Turner~
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*Note: |uoueU in Compliance with G.S. of North Carolina Chapter 130—Article 13o.
Permit Number
Nome ! ___- Date�' ! ` �����Locationre-
Subdivisi66 Name Lot No. Sec. or Block No.
Lot Size
No Bedroomn____
Garbage Disposal
Auto Dish Washer
Auto Wash Machine
Type Water Supply
-_~
House ______ Mobile Home Business ______-Speculation
7
No. Baths No. inFamily
___-_-__
YES :[:] NO Specifications for
YES [] N{} ��''
YES E]' NO C]
*This permit Void if sewage system described below is not in
Improvements permit by
*Contact a representative of the Davie County Health Department for final inspection of this oyob*m between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day of comp|ebon Telephone Number' 704-634-5985.
Final Installation Diagram:
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Certificate of Completion. Date
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'The signing of this. certificate shall indicate has been installed in compliance with
the standards set forth inthe above reg bataken aoaguarantee that the system will function
satisfactorily for any given period of time. ---
Installed by
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Improvements permit by
*Contact a representative of the Davie County Health Department for final inspection of this oyob*m between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day of comp|ebon Telephone Number' 704-634-5985.
Final Installation Diagram:
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1r
Certificate of Completion. Date
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/
\ [/
'The signing of this. certificate shall indicate has been installed in compliance with
the standards set forth inthe above reg bataken aoaguarantee that the system will function
satisfactorily for any given period of time. ---
Installed by
DAVIE COUNTYYsEfflff1PARTMENT '
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.'=' HOSPITAL STREET
R 0. BOX 665
MOCKSVILLE, NORTH CAROLINA. 27028
(704) M4 -6M
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DATE
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DETACH AND MAIL WITH YOUR CHECK. YOUR CANCELLED CHECK IS YOUR RECEIPT.
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FORM F082 Available from GRAYARC CO., INC., Brooklyn, NY 11232
DAVIL COUITY HEALTH DEPART11,
ENVIR0111.0ITAL HEALTH SECTION
SOIL/SITE EVALUATIOr
IIAIME 'Ja�� TaRu�rz DATE
ADDRESS 1� O. 'ZIP- WV
S
Z-71 0 q LOCATION
LOT SIZE
TOPOGRAPHY: �S 2
SOIL TE:;TURE :
SOIL STRUCTURE: U
je
DEPTH:
RESTRICTIVE HORIZOFS:
PERCOLATION RATE: Presoak
1. '
2. 12
3.
Hark & time Drop Time
Pate Hin. Inch
fu/i,� 10 , '' 3o O /o:
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***CLASSIFICATIOII:
Suitaule Provisionally Suitable Unsuitable
COMIEIITS : fr'adqc�g
SANITARIAII gGi�
SITE DIAGP,A.Mi
0
0
2