P2902 Mildred WhiteDAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
n/ Permit Number
Name % i i /i' i ;/ .0
7,/, , CT 2
Date
Location �/ y'/
Subdivision Name
Lot No,
Sec. or Block No.
Lot Size House
Mobile Home _ Lam. Business Speculation
No. Bedrooms _
No. Baths __
No. in Family
Garbage Disposal
YES ❑
NO
Specifications for System:
Auto Dish Washer
YES p
NO ❑
{ - ;,
Auto Wash Machine
YES P
NO C]
"f
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
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:
v
System Installed by Ay� S
s
Certificate of Completion< Date
i
*The signing of this certificate shall indicate that the system describ�fi 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 COUFTY HEALTH DEPART IE11T
ENVIR0111,1ENTAL HEALTH SECTION
SOIL/SITE, EVALUATIOU
LOT SIZE
TOPOGRAPHY:
SOIL TE,.TURE:
�
SOIL STRUCTURE: v " J/
DEPTH:
RESTRICTIVE HORIZOFS:
PERCOLATION FATE:
1.
2.
3.
LOCATIO:1
Presoak
Hark & time
Drop Time
Pate Hin. Inch
—Ago o
49- 1 i ?
***CLASSIFI 'Suitalile Provisionally Suitable Unsuitable
COMMITS:
SAFITARIAII