1805 Hwy 601N , .
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: |oouod in Compliance with G.G. of North Carolina Chapter 130—Article 13n.
Permit Number
Name ___-_ Date
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Subdivision Name Lot No. Soo. or Block No.
Lot Size House Mobile Homo -- Business --- Speculation -_----_-_
No. Bedrooms No. Baths No. in Fami|y-_-_-_-_
Garbage Disposal YES 0 NO ESpecifications for System: T\ OZ.
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Auto Dish Washer YES E - NO E]
Auto Wash Machine YES F]'-NO �F�
Typo VVotar Supply*This permit permit Void if sewage system described below is not installed within 38 months from date of issue.
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Improvements permit pennit bv
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*Contact u representative of the Davie County Health Department for final inspection of this oyo8am 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
*The signing of this certificate uheU indicate that the syste mdescribed above has been installed in compliance with
the standards set forth in the above regulation, but shallin NO way be taken as aguunonk»e that the system will function
satisfactorily for any given period of time.
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DAVIE COUNTY HEALTH DEPARTMENT _
P . 0. BOX 57
MOCKSVILLE , N. C . 27028
(7 04) 634-5985
Statement for Septic Tank Improvement Permits
and/or Site Evaluations
NAPIE DATE ISSUED
ADDRESS d4�F .5 ► �S PER14IT NO .
1Uct����\le IN4. a10a-y
Explanation of charge
AD40UNT DUE aDA SANITARIAN
PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEMENT.
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DAVIE COIRNTY HEALTH DEPART IT
AddeE.ss: ,P ,ii-s, 13�x- as-8
PERCOLATION TEST RESULTS cau; e.,A e:
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DATE
NAIME a)/(r dr 99,,W/-
LOCATION
9,,wwLOCATION r)fl w1o//V p x7- The,,-c 6316 AWV e-s
Tu2N l�Fr a►t a;.ei P.1J G�r�c9 e�
FINDINGS: HOLE 110. CO:iKE ITS
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P. O. BOX 57
�{i�nrl:sbillr, Zorth (rarolina 27028
OFFICE OF THE DIRECTOR TELEPHONE
1 -• Dn^ ^ i 1 704/ 634.5985
Mr. Dorman Drown
Route 5, Box 2.5 B
Mocksville, N.C. 27028
no: Soil/Sita Evaluation, House Under Const:, can, Cff Huy. 601N
Mr. [crown:
This office has made several evaluations Oft prcperty mentioned above.
The first evaluation was conducted en !1/1 /70, at this time the percolation
test holes were not ready. Lle returned on 11/15/7 and completed the perc
test. At this time we also tool: ,oil borins in ceder to inve::tigate the
quality of the soil
Although all the necessary investigations have been completed, we are in
need of further information before we can complete the permit. Please qct
in touch with this office as soon as c:ossible in order to clarify several
concerns this office has at the present time.
You are also hereby notified that ycu are in violation of HousE: Dill 296, in
that you have started construction, of a dt.iellina without first obtaining an
improvements permit from this office. In the future you are instucted to
contact this office before any construction bcc_r,s.
Sincerely,
Joe Nando, Sanitarian Supervisor
DAVIE COUNTY HEALTH DEPARTMENT
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