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173 Woodvale Dr Wo,"7 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 /1 ' 0 Location Subdivision Name Lot No. Sec. or Block No. Lot Size Z House Mobile Home Business --- Speculation No. Bedrooms 1Z. No. Baths No. in Family Garbage Disposal YES :E] NO E] Specifications for System: �Oc) Auto Dish Washer YES [:] NO 0 6 1-7' Auto Wash Machine YES E] NO C] Type Water Supply *This permit Void if sewage system described below is not installed within 36 months from date of issue. fi 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 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. F I DAVIE COUPTY HEALTH DEPAP.^IMITT ENVIROP MEBTAL HEALTH SECTION SOIL/SITE EVALUATIOU num NF P-1,4� �G. �t'IIRCf— 78'/-jjor- DATE Iq- k1 ADDRESS &X 54 CouL4Et�tE N c 27014 LOCATIOYd G LOT SIZE TOPOGRAPHY: S SOIL TEhTURE: y e . SOIL STRUCTU DEPTH: RESTRICTIVE HORIZOUS: PERCOLATION RATE: Presoal-, Mark & time Drop Time Rate/Nin. Inch 1. JQ` mit .33 " 20 2. .eq� ��. �o=3s 2� 2C 3. ! � 10`3C G i *"*CLASSIFICATIOTI: Suitable Provisionally Suita Unsuitable COMIEUTS: ✓`✓___--------�� SAR?ITARIAN SITE AGFA Z r O , r 1.