P2905 Livingston Rd i
'i 4ko DAVIE COUNTY HEALTH DEPARTMENT
r IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Date
Name .-��
e.d
Location
Subdivision Name �f Lot No. Sec. or Block No.
Lot SizeHouse Mobile Home --- Business Speculation
No. Bedrooms �� No. Baths No. in Family
Garbage Disposal YES p NO Specifications for System:
Auto Dish Washer YES E NO 'p ,
Auto Wash Machine YES p NO
Type Water Supply _—
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
M .
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
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. - - '
t
DAVIE COUNTY HEALTH DEPART MIT
ENVIRONMENTAL HEALTH SECTION
SOIL/SITE EVALUATIOU
ADDRESS � 1�
tlxx LOCATION
LOT SIZE
TOPOGR.APuY s -57
SOIL TE:�TURE s
SOIL STRUC ME a
DEPTH:
RESTRICTIVE HORIZONS:
PERCOLATION RATE: Presoak Piark & tine Drop Time Pate/iii%. Inch
1. //,-,/ !�U .c,- V
Z.
3.
**CLASSIFICAT .Srti 1 Provisionally Suitable Unsuitable
COMIEUTS e
SAFITARIAIJ
SITE DIAGPAY1