P2998 Sanford Ave Ext"Note: Issued in
-Z... 0-0
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
'ompliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name I�= ,; Date 4 _ c - t
Location �.
Subdivision Nam Lot No. Sec. or Block No.
Lot Size f•� House Mobile Home �-�'� Business Speculation
No. Bedrooms �9 No. BathsNo. in Family =-
Garbage Dispos I YES ❑ NO
Specifications for System:
Auto Dish Wash r YES ,p' -NO ❑
Auto Wash Mac ine YES E --NO ❑
Type Water Su ply _—
1,
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
Improvements permit by
`Contact a reresentative 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 ZZ�
'The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standaros set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactoril for any given period of time. .
G DAVIE COUPTY HEALTH DEPARTiIEidT
EPIVIRORNERTAL HEALTH SECTION
SOIL/SITE EVALUATIOP
DATE
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TOPOGRAPHY:
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DEPTH:
RESTRICTIVE HORIZONS: t,6Y
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Presoak
Hark & time
DroE7
Time
Pate tiro. Inch
°Suitable Provisionally Suitable Unsuitable
CUI�IEtI S
SAVITARIAII
SITE D AGF.AY1