P2765 Ridge Rd DAVIE COUNTY HEALTH DEPARTMENT
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IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
`Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name, 1111� r ,a ��,, 1 Date
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Subdivision Name Lot No. Sec. or Block No.
Lot Size 4, House Mobile Home _ Business Speculation
No. Bedrooms No. Baths 2 - No. in Family
Garbage Disposal YES !❑ NO E] Specifications for System: 1000 • %- `< ""
Auto Dish Washer YES p NO ❑ '
Auto Wash Machine YES Q NO �❑
Type Water Supply U--)< d . _ ! - i?��� -� , f r r.fc r�
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
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 by 12�uJf�f.l
- 71
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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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DAVIT COMITY HEALTH DEPART MIT
ENVIROIII ENTAL HEALTH SECTION '2 �,\� 5
SOIL/SITE EVALUATIOII
IIAIm �rly L P0,A 0 DATE 7—
ADDRESS I q -XeVU'",v M
PKTz,joo D t -1 11717 LOCATION �'(�G F �.
LOT SIZE
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TOPOGRAPHY:
SOIL TE:ITURE: CL A-1 La.�Yh
SOIL STRUCTURE: A-�-fi4LAIL, Q(,°cell
DEPTH:
RESTRICTIVE HORIZONS:
PERCOLATION PATE: Presoak Mark & time I Drop Time Pate/Hi.n. Inch
1. �. cam.._ ��•�S � �Sr GyU,,�•
2o
3. 3 � Yn1� (v•.�S �
***CLASSIFICATIOII
Suitable. Provisionally Suitabl Unsuitable
C01511E ITS:
SANITARIAN
SITE DIAGRAMI
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