289 Pinebrook Dr . , 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 i..e – -- -- — Date
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size ` House Mobile Home _ Business Speculation
No. Bedrooms f No. Baths No. in Family -�
.Garbage Disposal YES ,p NO p
Specifications for System:
Auto Dish Washer YES p' NO p i'•.';.;1 ._s'
Auto Wash Machine YES O NO
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue//.
If
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1 i
f f
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i 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
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Certificate 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.
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DAVIZ COUP?TY HEALTH DEPART." ENT
ENVI'ONIENTAL HEALTH SECTION
SOIL/SITE. EVALUATIOIT
I?AIS 2 t�to `J C°o- — 6 3 p 7.3 7 DATE
ADDRESS .'?O rncC.v,
M o c K5 d,I It 12 c- 2,70 2- LOCATIO14 qr rr.t�io•�n►� �8 -
"1• ate, r. � •.ve. - l,oT o �e Cry e.K..
LOT SIZE Mt acrtS
TOPOGRAPHY: eXcellt„T
N
SOIL TEA:TURE:-Toast,L b o-12," rc ov.!looms - 3 tAco-1, loaw,.� t}v o if r14, 24 -5� -1"►+�.r.S
-'Tb a r,4m T%&S' j Qr m.'i��ure aF 5o i 1 i- t^,+•wc�aloC,� C FA'.�-`�Cor�
SOIL STRUCTURE: jopr
DEPTH: �oob2 aen Z�e. 1. o p 2te- 18"- S%4*. o.� �`- 3 '-" -UnSuX Oki- 3 �- 3'/si
RESTRICTIVE HORIZOVS: st-S%h+ ems,Jt^o-e a; m.400s -,,. 3q-"
Savo— racx- L pt edtz
PERCOLATION RATE: Presoak Hark & time Drop Time Pate/Ilin. Inch
1. E b�' o:va 3/v•, ,e:.3 2 11141 o�
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2. k aru� fF �f�: 33 /2d cr .Ad 9s-i+s/��
3. Ew + :o �44d
***CLAS SIFICATIOPI:
Suitable Provisionally Suitable Unsuitable
COMIEUTS
SAA?ITARIAPT
SITE DIAGRAM �,�-
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