162 Hillcrest Dr (2) =
DAVIE COUNTY HEALTH DEPARTMENT
� 'xmm��m '� ~
. ROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
Note: Issued in Compliance with G.S. of North Carolina Chapter 13O--Arbn|e13o. ,
. Permit Number
/- ( � » '�'� ����
Noma ��' ' ---__- Date ' ' ��-�«���
Location
Subdivision Noma Lot No. Sec. or Block No.
Lot Size ^ House Mobile HomeBuoineoe -__----_' Speculation _----__--
� ^ .^-
No. Bedrooms __-��-__ No. Baths-___-_-_ No. in Fami|y---_--___
Garbage Disposal YES [-1 NO for
SpecificationsSystem:Auto Dish Washer YES El NO El
Auto Wash Machine YES NO �-1
Type Water Supply '
. .
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
` -
Improvements permit by
`
. \
�
`
\
J \ \
� )
_ !
` \ '
`
m |
\ '
/
'�.
^
*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.
rxuu o,,u*/uxm/ D/*S/=xx. System Installed. . by
Certificat of Compl tion Date
. '
*The signing - —ia certificate shall
5that ' has been installed in compliance with
the standards shall fo�h |nthooboveoagu ' inlway Uetaken annguarantee that the system will function
satisfactorily for any given period of time.
DAVIE COUNTY HEALTH DEPARTMENT
a -
PERCOLATION TEST RESULTS
DATE
Ratae 2 ,'Bat 108'
NAME �GI�h\5 Ca.Tet` ArIU wit
LOCATION gD� Ta Adua \ce V7rs�- RsT lo►..1n�el `�uharft_ �'c� •
'S �� �p R�. S W�a IL, rt r.te� yy► 10� 6f'YWt?tom AriC.,� hvuSC$
FINDINGS: HOLE NO. COMIENTS
2�f
e(Jw.'�Wo1i, . JL I3U� �DOYti•ti'iyrL Ido ¢u��Yw-t� y� Mc- t�c $ a�'v. �laPro�•��,
3. 3WL,�r
13y%.. .. yo w;...
4 z1-0
S. aufnki,
b.
BY:
LOT DIAGRAI-1
X14
pPProx;rM eJe I y a q o IV loo Faef Derv,; s CAS+e,-
'' ,a
of 2 acre, more- or less 'Tenn;Fer Mgfles
C)9$- 24 ) 31
pd n� p
�pin�" pn
pence.
All)" r�� ,7d7�
a�
vi �: b
PrOPD5ed Siff For
Mo61le. home
I 0 test o +est
1 ho)&
hole.
�I
t
L
I
-ti 1
¢I
3
I
Id
3 0 hI
o J
nil �
1 I !S
�Cin� A+ I �Oir1T i n
iron rod &arde,r,
s /6,24
Saa�� east SrG�G oL ��avec/ /�or�:or�
of s,e �l9a y, I
r
Mocks OhlirrA el,
s
ls-9
o a �oc�f 3 ,.,:les a�, eol
4V 5 R 119 at q . /A;si s 71-1i e- Fi'is r OnGr
on 4-Ac- r-�M
1nr�Le� �Gi11Gymn //
"n /0.7 �e t le e 4-w o
back I,owses.
DAVID; COUITY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SECTION
^�,� ..__. .�,• P.O. BOX 57
MOCKSVILLE. N.C. 27028 Yk
(704) 634-5985
STATE1211T FOR SEPTIC TANK I.^'XROVEMENTS PERMITS AND/OR SITE EVALUATIONS
NAP4E A c, =b �a+ c DATE
ADDRESS R .fit a =?,�� lc`X PERMIT NO. -BALM
-���v�ncc� n. �. al�'sl•
EXPLANATIOI4 OF CHARGE��1c e u aJ. u-.n,A
AM0UNT DUE
_20.n SANITARIAN fYx t,,
PLEASE REMIT THE ABOVE ZU40UNT OF RECEIPT OF THIS STATEMENT.
*NOTICE: Evaluation(s) can not be completed until payment is received.
Improvements Permit(s) can not be issued until payment is received.