447 Junction Rd DAVIE COUNTY HEALTH DEPARTMENT
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IMPROVEMENTS PERMIT AND. CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.S. of North Carolinaf.Chapter 130—Article 13c.
- - Permit Number
Name Date
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Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size i - House Mobile Home Business Speculation
No. Bedrooms No. Baths - No. in Family
Garbage Disposal YES ❑ NO p Specifications for System:
Auto Dish Washer YES ❑ NO p-
Auto Wash Machine YES ❑- NO ❑ , r',r./
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 1� `-
*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 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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DAVID COMMY HEALTH DEPARTNEUT
PERCOLATION TEST RESULTS
DATE 1- 3-80
LOCATION
FINDINGS: HOLE 140. COMMENTS
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LOT DIAGRAM
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DAV'tE, COUNTY H'�AL`tH DEPyARTi*2ENT
-F4OCKSVILLi f� N C. 2702'8 ;.,f or°
(704) 63*259$5`11
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Statement for Septic Tank Improvement- Permits
and/or --Site Evaluations
NAMEcxrvttti DATE ISSUED ! ' ' R� I
ADDRESS t�v��-}e, 7, '331 PERMIT NO. ,3v
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Explanation of#�'char'ge c euJ. -� nvt•-e.,. 7_c,.,.,�
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A`MOUPT DUE or"tA SANITARIAN
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PLEASE R4141T T4iE ABOVE AJ•iOUNT ON RECEIPT OF THIS STATEMENT.
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