319 Markland Rd A
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
_ Permit Number
Name Date '.. c f j % ,!
Location Z.) ///i..,�,.
Subdivision Name Lot No. Sec. or Block No.
Lot Size' House x� Mobile Home _ Business Speculation
No. Bedrooms No. Baths ? No. in Family
Garbage Disposal YES ❑J" NO Specifications for System: v n_ «� 14^1
Auto Dish Washer YES [D--N0 ❑ , �- >
Auto Wash Machine YES p NO ❑ �« r' - «-fes L�f sy��
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: System Installed by5rAIGOtJ (0Z0i�7 7-Z-4 -
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- y L
Y
Certificate of Completion ` 1---�� Date - 7_
*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 COUNTY HEALTH DEPARTMENT
P . 0. BOX 57
MOCKSVILLE, N. C . 27028
(704) 634-5985
Statement for Septic Tank Improvement Permits
and/or Site Evaluations
NAME Je4'F �cnna�Z DATE ISSUED 9-#;L�-
ADDRESS ,�,�{-� a PERMIT NO. ;?/ 7/
Explanation of charge
AMOUNT DUE �d •eWJ' SANITARIAN
PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEMENT.
DAVIE COUNTY HEALTH DEPARTMiT
PERCOLATION TEST RESULTS
DATE
LOCATI IN
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CIL-
FINDINGS: HOLE P10. COMMENTS
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P. Q. BOX 87.
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OPfICE OFTH�,OIRECT4R TELEPHONE
. 7041 834.5985 s
June 5,'1979
" Mr. aeff, Cornatzer
RQute2
r, Advance#' N:C'. '27006
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d �: �Ix�d �ornatzer;
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a, ', , Ori sune'4, .1979, .at your request,I 1.your property located on Markland
,� '-; Road was evaluated by this office; for the purpose of installing an -nn-site
.,
sewage disposal system. From the reII sults of our eval.1 Iuation your property
has been""classified As provisionally suitable. laI.Ilo have designed a sewage
system based upon the information you gave` us and also based upon the facts i':.
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as were` found in the evaluation. The soil qualities are such that a little
x lar er :s she than-usuall shall beacalled for.
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P,aease %find enclosed a statement for �20.Op. This charge .is for "the
evaluation and "the' Improvements Permit. Upon' receipt 'of this charge; w"e will;
fprwa-d tie =permit to :you at,once.
�; If you �.hould .have any questa�on .feel free to. contact_this office.
Y � t
W, S I .1noerely
6 �, ` V ��
� ' �oe`'Mando, Sanitarian Supervisor
P ,Y: �A
'"` Uav�e' County Health DepartI, rment
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