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751 Joe Rd 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 n Name ,� � ,e t r l�4i '( F 17 i rj s Date �" ry r r . n. a Location Subdivision Name Lot No. Sec. or Block No. Lot Size 1 L s" ` House Mobile Home _ `r� Business Speculation No. Bedrooms - No. Baths 2- No. in Family --' Garbage Disposal YES ❑ NO ❑ Specifications for System: /000 Auto Dish Washer YES ❑ NO © —, U` f oN Auto Wash Machine YES [E' NO E] , Type Water Supply its it j; V *This permit Void if sewage system described below is not installed within 36 months from date of issue. Ti i I e0 i s 1'i'i O f L 4 It i . i h i L li. 0'>t.J J J i `D Improvements permit by . S:;2'<"' 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. Final Installation Diagram: System Installed by �� \ti0 t l Certificate of Completion'�50'�'/' - Date V *The signing of this certificate shall indicate that the system describe 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 Environmental Health Section R 0. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Name 6eoa6F /V�FF i'r i Date " Z S 83 Address 3 2>"x /9� Lot Size i'6,' 17 �L J)IAMeXV1 Lt r- X/c FACTORS AREA 1 AREA 2 AREA 3 AREA 4 1) Topography/Landscape Position S S S b ® PS PS U U U U 2) Soil Texture (12-36 in.) Sandy, S S S S Loamy, Clayey, (note 2:1 Clay) 0 US US 3) Soil Structure (12-36 in.) SS S S Clayey Soils PS PS U U U U 4) Soil Depth (inches) S , S S S g � PS PS U U 5) Soil Drainage: Internal 1 S S S P � PS PS U U U External S S S S Com' ® PS PS U U U U 6) Restrictive Horizons 7) Available Space � S S © PS PS PS U U U U 8) Other (Specify) <5:7,> S S PS PS PS PS U U U U 9) Site Classification U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable Recommendations/Comments: aPo6 Co�� CifvsF , 20 S Described by Title s�N� rrcruan/ Date SITE DIAGRAM DCHD(6-62)