Loading...
346 Rollingwood Drive Lot 11 Section 3" F t DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance With Article II of G.S. Chapler 130a �V/ jSanitary Sewage Systems �J)Jxe,,y/. Permit Number Name Ae•L�'0 �A/1' /Z �f 1�A-w Date ,A/2,�2 N9 5826 Subdivision Name ����� �`( Lot No. Sec.. or Block No. 3 Lot Size House Mobile Home _ , Business --- Speculation No. Bedrooms— .! No. Baths No. in Family Garbage Disposal 'YES ❑ NO Er AE]Specifications for System: Auto Dish Washer YES NO Auto Wash Machine `+i YES NO p Type Water Supply n�.` _ �B�X�X�i• *This permit Void if sewage'system described below is not installed within 5 years from date of issue. This permit is subject to revocation if site p aT-n3"6Tthe-int ed use change. 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. c µ [h Y. L� • t 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. APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department 6 Environmental Health Section P� Z P. 0. Box 665 v(G� Mockaville, NC 27028 N6 1. Application/Permit Requested B,, ,"yy/�4//� /v/ Mailing Address /er C/ sox V�// Home Phone ZPr ��Q Business Phone 2. Name on Permit if Different than Above 3. Property Owner if Different than Above � 24 4. Application/Permit For: General Evaluation 7�1T u/Tank Installation 5. System to Serve: use Mobile Home Q Business LC] Industry G Other 0 Unknown 6. If house, mobile home: Subdivision Sec. 3 Lotn No. of People Z Dwelling Dimensions J2>eSly" No. of Bedroom Basement/Plumbing No. of Bathrooms Basement/No Plumbing Washing Machine Dishwasher Garbage Disposal 7. If business, industry, other: Specify type No. of People Served No. of Commodes No. of Lavatories _ No. of Showers B. Type of water supply: 9. Property Dimensions t"Public o No. of Sinks No. of Urinals No. of Water Coolers 0 Private p Community zoo a> IV 1&44 10. Sewage Disposal Contractor 11. Do you anticipate,additions/ex ansions of the facility this system is intended -to serve? 0 Yes If yes, what type? *NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. This is to certify that the information provided is correct to the best of my knowledge, and I understand I am res onsible for all charges incurred from this applicatio . — 26 =-'ZO Date ,��J n S1 / tura/ ' fitr( y 14001 "�10uC3 ✓/GI.Z V0 Directions to Property: �,t�IiY` cSitL't a3 �. iLogoP DCHD (10-89) 0 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Box 665 Mocksville, N.C. 27028 ] / SOIL/SITE EVALUATION Name- Date 021c2a/ ly /� -d Address Lot Size ��0tl2e�b FACTORS AREA 1 AREA 2 AREA 3 ARFA d I) Topography/ Landscape Position 8) 9) cp PS © PS Q PS S U U U U 2) Soil Texture (12-36 in.) Sandy, Loamy, Clayey, (note 2:1 Clay)-� S S Si¢�S� S_ 3) Soil Structure (12-36 in.) Clayey Soils S ��� S— ��,x S U U U U I) Soil Depth (inches)_ i i) Soil Drainage: Internal External P i) Restrictive Horizons Available Space S PS PS (s TrS U U U U Other (Specify) S PS S PS S PS S PS U U U Site Classification - - pU p� ` +' U—UNSUITABLE S—SUITABLE—Provisionally Suitable Recommendations / Comments: Described by Title �7y1/ Date SITE DIAGRAM DCHD (6.82