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P2297 Ponderosa RdDAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c. Subdivision Name Lot No. Sec. or Block No. Lot Size r�-," ' House Mobile Home _ �- ---- Business Speculation No. Bedrooms No. Baths Z No. in Family Garbage Disposal YES :❑ NO ❑''' • Specifications for System: Auto Dish Washer YES NO Auto Wash Machine YES ?/© NO ❑ /� ,;�� ` j' ,%'✓_"ifj Type Water Supply'%moi' _ `This permit Void if sewage system described below is not installed within 36 months from date of issue. s , Improvements permit by r - *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 iL Date Z� .� *The signing of this certificate shall indicate that the system described above h/as 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. Permit Number Name ti i,%�� ` .��' �, _1,�' Date _ Location ' Subdivision Name Lot No. Sec. or Block No. Lot Size r�-," ' House Mobile Home _ �- ---- Business Speculation No. Bedrooms No. Baths Z No. in Family Garbage Disposal YES :❑ NO ❑''' • Specifications for System: Auto Dish Washer YES NO Auto Wash Machine YES ?/© NO ❑ /� ,;�� ` j' ,%'✓_"ifj Type Water Supply'%moi' _ `This permit Void if sewage system described below is not installed within 36 months from date of issue. s , Improvements permit by r - *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 iL Date Z� .� *The signing of this certificate shall indicate that the system described above h/as 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. DAVIE COUI= HEALTH DEPARTMUT PERCOLATION TEST RESULTS DATE NAIME LOCATIONil�� FINdDINGS: HOLE 140. ,off ,r7 /f 4kltl S LOT DIAGM1 Ll 0 0 CWMAMITS By: F. Y V t DAVIE COUNTY HEALTH DEPARTMENT 1 P. 0. BOX 57 Q,' MOCKSVILLE, N. C. 27028 jjJJ (704) 634-5985 Statement for Septic Tank Improvement Permits and/or Site Evaluations NAME SDATE ISSUED ADDRESS" PERMIT NO. j Explanation of charge liir r„ AMOUNT DUE SANITARIAN PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEMENT.