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P3064 Main Church Rd
i *Note: Issued Name i Location Subdivision Lot Size !� No. Bedrooms Garbage Disp( Auto Dish Wa: Auto Wash Ma Type Water S *This permit V DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION n Compliance with G.S. of North Carolina Chapter 130—Article 13c. Permit Number R _• � .�, �' _ Date `n Lot No. Sec. or Block No, House Mobile Home Business Speculation No. Baths No. in Family ,al YES ❑ NO ❑' Specifications for System: er YES NO hine YES] NO ❑ _ pply _ -- id if sewage system described below is not ins6ir& _ /L/impr vements'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 :00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985. Final Installati n Diagram.--- �`� i' System Install *The signing c the standards satisfactorily f i Certificate of Completion Date this certificate shall indicate that the system described above has been installed in compliance with at forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function any given period of time. Address FArTnRS 01 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section R 0. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Date Lot Size ARFA 1 AREA 2 AREA 3 AREA 4 Topography/Lan scape Position S SS CN)PSPS U !) Soil Texture (12436 Loamy, Clayey, (rote in.) Sandy, 2:1 Clay) S PS S PS U U 1) Soil Structure (12 Clayey Soils 36 in.) S PS S PS S S U �) Soil Depth (inche) S S S S i) Soil Drainage: Int rnal S PS S PS S S External S S S S PS U U i) Restrictive Horizons ') Available Space S Ste—., C. 'UU U� 1) Other (Specify) S PS S PS S PS S PS U U U U !) Site Classification U—UNSUITABLE S—SUITAB E S—Ponaliy S ( recommendations/ omments: Described by SITE DIAGRA D&D (6-82) el"el Al Date VAIT, ADDRESS LOT SIZE DAVIT COUFTY HEALTH DEPARTMITT ENVIR01II2IITAL HEALTH SECTION SOIL/SITE EVALUATIOU DATE 6 -25- - P 2 TOPOGP IPHY SOIL T,«TURE: SOIL S RUCURE: DEPTH: ©-- RESTRI TIt HGP,IZOI?S : LOCATIO'td 2,.�t- PERCOL TION PATE: Presoak �� 2. 3. vw Bark & time Drop Time Rate rIin. Inch •b "�(�JG� D 0 i o ** *CLA�'SIFICATIOI?Suitable Provisionally Suitable Unsuitable C0191,0I US: SANITARIAF? 1".4,✓Dd SITE DIAGRAM Ott ti -42S/ T ctt C� n eAP