330 Angell Rd (2) DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorpt on Sewage Disposal System - G.S. Chapter 130-Article 13C)
OWNER OR CONTRACTOR DATE PERMIT
LOCATION ,-"� ; i� f s'�`; .�, Z''. ,_
819
' .R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE MOBILE HOME E3 BUSINESS ❑
,,� J House Trailer 800 Gal. 400 Sq. Ft.
N0. BE ROOMS N0. BATHROOMS '�-"
-_–�,.`.�— ���. Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO d Three Bedroom House ,900 Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES ❑ NO Q'' our e room'T16usoue 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES NO ❑
SITE SUITABLE YES ❑ NO '
SIZE OF TANK ,a gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY � ^' }
;.� - -., INSTALLED BY l ., --
CERTIFICATE OF COMPLETION
By Date r
(8/16/73) *Construction must com�.�y with all other applicable State and local regulatio s
LOT AREA /71
t
: r
l DAVIE COUNTY HEALTH DEPT.
PERK TEST RECORDS
DATE Ja
NAME
LOCATION ,-�,
C e COMMENTS
FINDINGS: HOLE Pd0.1 � �_
3 r)3 M<� ��
HOLE NO.2 �D
HOLE NO. 3 l
BY /
d
LOT DIAGRAM LrJ
4
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- yy
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�M�1iC - 'U�tl��tilt
MS. CONNIE L. STAFFORD 803 HOSPITAL STREET TELEPHONE
DISTRICT HEALTH DIRECTOR P. O. BOAC 57 704/ 634-5985
A3nche1Ti11c, Norfli Carolina 271128
December 17, 1975
Vernon Whitaker, Jr.
Angel Road
'Mocksville, N. C. 27028
Re; Perk Test Results
Dear Sir:
The perk test were run on 12-15-75 on your property on Angel
Road at the sharp curve. The results were very poor, the best
one being on inch of water absorbed in 160 minutes. From these results
we can not recommend that a septic system be installed. Since you
do have several acres here we will issue a permit on the condition
that in the event the septic tank system should fail, the Health Dept.
will be notified immediately so that a permit may be issued for repair
or replacement of the system.
If you agree to these conditions, please sign the carbon copy
and return to this office. If we can be of further service please
let us know.
• Very truly yours,
R. J. Duncan
RJD/gh
I agree to the condition stated above.
� m Vernon Whitaker, Jr.