224 Swicegood St 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 ' .
Locational rr,ti�PPt�.re i 1�. 1 S . :, f, e r,
CLAC1 -I r e ✓ r f . �� �
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Subdivision Name Lot No. Sec. or Block No.
Lot Size 1 n c^-c_ House ✓ Mobile Home _ Business Speculation
No. Bedrooms 2 No. Baths I No. in Family
Garbage Disposal YES ❑ NO p, Specifications for System: ?ao
Auto Dish Washer YES ❑ NO ❑
Auto Wash Machine YES ❑ NO ❑
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 Nu ber: 704-634-5985.
Final InstallationDiagram: System Installed by(N0L '!-�r��1-0,
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Certificate of Completion S\ (T (i—JDate �� b
'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 DEPART TEITT
ENVIRONMEBTAL HEALTH SECTIOPT
SOIL/SITE EVALUATIOI?
DATE
ADDRESS /� 0•
CC4,1ftZee'z IU 270/SL LOCATION
c,�r.(' c�� sT S .�+-�— w '�• � L��-ria-ve-
LOT SIZE--
TOPOGRAPHY:
IZE -TOPOGRAPHY: Eefcellk-
..:r���
SOIL TE:,'.TURE: 9" �jcpao:L o<S &O
SOIL STRUCTURE:yd"-9•"`•
DEPTH. S-o.'G - r-
RESTRICTIVE HORIZOUS:
PERCOLATION RATE: Presoak Bark & time Drop Time FateiHin. Inch
1. � (9 " ;vv //Z- 2.•3o Zan, 4,
2.
3.
112
**CLASSIFICATIOIT°
Suitable Provisionally Suitable Unsuitable
COMIEISTS:
SANITARIAII oil
SITE DIAGF�