2076 Milling 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.
Permit Number
Name Date _ ° / 7
Location /f� < < cr��1(,- lid /1c.�1�s� j ;<<,rynj�c rjJ p ,>. —
n
Subdivision Name —_-__ Lot No. Sec. or Block No.
Lot Size i" /T
c, House �'`� Mobile Home — Business Speculation
No. Bedrooms 3 No. Baths No. in Family 2'
`Garbage Disposal YES p NO 0..111 Specifications for System:
Auto Dish Washer YES p NO p
Auto Wash Machine YES p NO p ?OU 3, �r �� Si
Type Water Supply66
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
Improvements permit by.
i
*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.
737
Final Installation Diagram: System Installed by C,�'n� r�S
Certificate of Completion 1(�,..� 1° Date
#The:si nin -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.
s
DAVIE• COUNTY HEALTH DEPART.-M-TT
ENVIROF11ENTAL HEALTH SECTION
SOIL/SITE. EVALUATIOIT
21 af (tel£ 6��s DATE / - :7— V
ADDR ESS JfO &-4IL-SNS/TQC --NZ/U�-
cj` S N Z7/d LOCATION MlCCrNC /22
LOT SIZE
TOPOGRAPHY: ��
SOIL TE;TURF:
SOIL STRUCTURE:
DEPTH:
RESTRICTI`JE HORIZONS: �(J�►--�
PERCOLATION RATE: Presoak Hark & time Drop Time Pate iiin. Inch
1. 7' 4. g= s�
2. 7" y:sc
3.
**CLAS S IFICATIOY?:
Suitable Provisionally Suitabl Unsuitable
COMMENTS:
SANITARIAN
SITE DIAGP"
3
6 I D
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