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1336 County Line Rd (2) 'A DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *Note: Issued in'Compliance with G.S. of North Carolina Chapter 130—Article 13c. ,k , Permit Number � "72 ! Name - _ Date Location — ,- _ w Subdivision Name Lot No. Sec. or Block No. Lot Size House Mobile Home — Business Speculation No. Bedrooms No. Baths No. in Family Garbage Disposal YES NO Specifications for System: 90 Auto Dish Washer YES [] NO E] f Auto Wash Machine YES Ep NO 0 �� Type Water Supply �V� ✓t -- ��,> - �,`rv�' ,,:�,.M �',�•�L��r`�_ *This permit Void if sewage system described below is not installed within 36 months from date of issue. i f 1 � Improvements permit by�11r *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: 704-6-3-4-5985. Final Installation Diagram: System Installed by--j R t'�1'► ��� ti" 1 J lJ Z� !�`��� - - Certificate of Completion � Date 0 *The signing of this certificate shall indicate that the system described1above 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 COUFTY HEALTH DEPART IEAIT ENVIRONMENTAL HEALTH SECTION SOIL/SITE EVALUATIOP DATE / ' 2-3 r 92— ADDRESS-9 2—ADDRESS9 IJ S 'y`�' ✓��. 2 �� LOCATION LOT SIZE /3 TOPOGRAPHY: SOIL TE,',TURE: /LTA GL{ t �dh t 1 SOIL STRUCTURE DEPTH: . RESTRICTIVE HORIZONS: PERCOLATION RATE: Presoak Bark & time Drop Time Rate Yiin. Inch A`: 3 ) 2. 3. ,d :Ys yZ 4 ***CLASSIFICATIOIT: � Suitable Unsuitable COAP-,IEITTS: SANITARIAFT �'" " SITE DIAGFAM 3 a c z