Loading...
869 Woodward Rd - South Fork RanchDAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c. —= Permit Numhar Name `�� ± c �c_ y< (•.r 5 C_ 1 l Location ►'� V. Date (-(.1��I Subdivision Name Lot No. Sec. or Block No. Lot Size House Mobile Home _ Business Speculation No. Bedrooms No. Baths No. in Family Garbage Disposal YES ❑ NO p' Specifications for System: cJU� � � � ������ `t-•^ L Auto Dish Washer YES ❑ NO gf %11�L, J / 5 ru Auto Wash Machine YES p' NO r-1' Type Water Supply *This permit Void if sewage system described below is not installed within 36 months from date of issue. r(�,N (-`L 3 a1z /00 ' �l"jliS 't)rrit(Lor,J 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 0 Cd7ntPCf n'3 SyS7-9 No 1 5'L!W Certificate of Completio � Date6 ✓ �J� *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 DAVIE COMITY HEALTH DEPARTHIE ?T ENVIR0111Mc1TAL HEALTH SECTION r" SOIL/SITE EVALUATION ITA14E SIO O -PA f oiZ l` K= ADDRESS ( - ( . `la'Q1C 9� Y1^"c-V-S\1I LLQ ts-r- 27 0 LOT SIZE TOPOGRAPHY: SOIL TE:'TURE : a � ! SOIL STRUCTURE : &LPk-SS I v C DEPTH: RESTRICTIVE HORIZOt?S: PERCOLATION RATE: 1. 2. 3. DATE G Lf -- &-/ LOCATION � ALJ �� 1ZV, Presoak Hark & tine I Drop Time Pate/iii%. Inch %*CLASSIFICATIOP?:suitable Provisionally Suitable Unsuitable COM1,IETITS : SANITARIATT� SITE DIAGPAM DAVIE COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH SECTION 'r P.O. BOX 57 1i MOCKSVILLE, N.C. 27028 q.4 (704) 634-5985 (0 STATE:017T FOR SEPTIC TANK IMPROVEMENTS PERMITS AND/OR SITE EVALUATIONS NAME vTH F4 R K RA rJ L DATE ADDRESS �ZT • (C> 1w "� -(� PERMIT NO. 7.733 wwc.K.S VI «f� IJ C- 7,7o 2 $' EXPLANATION OF CHARGE AMOUNT DUES SANITARIAN PLEASE REMIT THE ABOVE AMOUNT OF RECEIPT OF THIS STATEMENT. *NOTICE: Evaluation(s) can not be completed until payment is received. Improvements Permit(s) can not be issued.until payment is received. DAVIE COUNTY HEALTH DEPARTMENT �r IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION `Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c. Permit Number Name Date Location Subdivision Name Lot No. Sec. or Block No. Lot Size House Mobile Home Business Speculation No. Bedrooms No. Baths No. in Family-- Garbage amily _Garbage Disposal YES ❑ NO ❑ Specifications for System: Auto Dish Washer YES 0 NO ❑ , Auto Wash Machine YES ❑ _ NO ❑ Type Water Supply *This permit Void if sewage system described below is not installed within 36, months from date of issue. i r 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 r:. 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. DAVIE COUNTY HEALTH DEPARTMENT = 'IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION `Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c. _ Permit Number Name " 3 i f.r, is t�f� ,.< Date "' 2 FS. Location Subdivision Name Lot No Sec. or Block No Lot Size , - House Mobile Home Business Speculation No. Bedrooms No. Baths No. in Family Garbage Disposal YES ❑ NO p Specifications for System: Auto Dish Washer YES ❑ NO ❑ ,. ,._ , fJ, , �, ,_ r_' y� Auto Wash Machine YES p NO C] Type Water Supply *This permit Void if sewage system. described below is not installed within 36 months from date of issue. j 1. S,r. •?. i i - - - - I ---� - - - . - 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 byC— 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. DAVIE COUNTY HEALTH DEPARTMENT a 1NPROVEMENTS PERMIT AND CERTIFICATE' OF COMPLE"V_- issued 1r, "60 with G.S. of North Carolina Chapter 130—Article 136. 1�,%� Permit Number Nam�2ay ✓dir Ave Date AN0 2562 "dam �.,�V �iK" Location Subdivision Name Lot No. Sec. or Block No. Lot Size' House Mobile Home _ Business Speculation No. Bedrooms —yam No. Baths __ No. in Family Garbage Disposal YES ❑ NO p-- Specifications 'f Sy tem: y '/ Auto Dish Washer YES ❑ NO ©��(a Auto Wash Machine YES ❑ NO p ­— Type / Type Water Supply -Jl, *This permit Void if sewage system described below i n installed within 36 months from date of issue. I30 l �x A r -0 - �1 Improvements permit by .WE *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. DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION Note. Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c. Permit Number Name ` Date Location _ Subdivision Name Lot No. __ Sec. or Block No. Lot Size House Mobile Home — _ Business Speculation No. Bedrooms No. Baths — No. in Family _ Garbage Disposal YES ❑ NO Ej- --- Specifications for. System: Auto Dish Washer YES ❑ NO ❑ Auto Wash Machine YES ❑ NO ❑ Type Water Supply _ `This permit Void if sewage system described below is not installed within 36 months from date of issue. 'Mc.(441 vffecd i ctAs 0 F S S ct % d 121-1 )(3"IC L 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 Ift�Apd 7 r� `s /I ,u 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. i r i ! F ' t i s X1 i 'Mc.(441 vffecd i ctAs 0 F S S ct % d 121-1 )(3"IC L 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 Ift�Apd 7 r� `s /I ,u 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. DAVIE COU14-TY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION --�uteJaeued in Compliance with G.G. of North Carolina Chapter 130—Article 13c. _ Permit Number ^� Nome Date�� ��u~ Location � ` Subdivision Name Lot No. Sec. orBlock No. Lot Size House Mobile Home Business Speculation No. Bedrooms No. Baths No. in Family Garbage Disposal YES 0 NO E]------ Specifications for System: Auto Dish Washer Auto Wash Machine -----' ` ^.e Water Supply *This permit Void if sewage system douohbnd below installed within 36 months from date of issue. . \ � � \*.l`.u�'']) u)N~uv^ Ck- »' L \`� \ ] |/; 0 -- �f'\ L� ^� ��°– v� U(, /` |mprovemontspermit by *Contact a representative of the Davie County Health Department for final inspection of this system between 8:30- 9:30 A.M. :3O'S:3OA.K4. or 1:00'1:30 P.M. on day ofcompletion. Telephone Number: 704-G34'5S85. ' Final Installation Diagram: System61 x ^� \ / (` � , Certificate of Completion Date 'The signing of this certificate shall indicate that the system described abuva has been installed in compliance with the standards set forth in the above vegu!adion, but ahoU in NOway botaken as guarantee that the system will function satisfactorily for any given period of time. � � � |mprovemontspermit by *Contact a representative of the Davie County Health Department for final inspection of this system between 8:30- 9:30 A.M. :3O'S:3OA.K4. or 1:00'1:30 P.M. on day ofcompletion. Telephone Number: 704-G34'5S85. ' Final Installation Diagram: System61 x ^� \ / (` � , Certificate of Completion Date 'The signing of this certificate shall indicate that the system described abuva has been installed in compliance with the standards set forth in the above vegu!adion, but ahoU in NOway botaken as guarantee that the system will function satisfactorily for any given period of time. � DAVIE COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH SECTIOti P. O. BOX 57 MOCSSVILLE, N.C. 27028- (704) 634-5985 Statement for eptic Tank -Improvements Permits and/or Site valuat'ons NAME�,/!�! DATE ADDRESS ,e7 PEPTUT 140. � � 9 f EXPLANATION OF CHARGE AMOUNT Dur SANITARIAN PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEMENT. *NOTICE: Evaluation(s) can not be completed until payment is received. Improvements Permit(s) can not be issued until payment is received.