470 Calahaln Rd DAVIE COTINTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT -AN D•CERTIFICATE OF COMPLETION
*Note:Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name �,,L,�, �, \ r �'- i �.,•, h Date
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home — Business Speculation
No. Bedrooms No. Baths No--in Family ? C!. r c. '
Garbage Disposal YES ❑ NO p N
Specifications for System: jzn
Auto Dish Washer YES ❑ NO ❑
Auto Wash Machine YES ❑ NO p-
Type Water Supply _—
*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
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*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: K- System Installed by
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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.
DAVIE COUFTY HEALTH DEPARTIENT
ENVIRONi-ENTAL HEALTH SECTION
SOIL/SITE EVALUATIO11
VAX _ ��r.• 11c�.. r,{ti�s�: Q c�raTJ�C�, DATE /o - 7—P!
ADDRESS
LOCATION w yr•-
LOT SIZE
TOPOGRAPHY: Sc.k,blc �D���[� �•� �Ce��J ��
SOIL TE,-''TURE: '- S-,-—Wc �'+ 1� r� •�
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SOIL STRUCTURE: r'1 Ste'• 4bk
DEPTH: t{g " '•
RESTRICTIVE HORIZOES:
PERCOLATION RATE: Presoak Mark & time Drop Time Rate/Yiin. Inch /
Z til-
7:
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3. b,
* CLASSIFICATIOi1:
Suitable Provisionally Suitable Unsuitable
C01MEYIT S: a uo v S
SANITARIATI O,
SITE DIAGFAY1 _�....