P2429 Howell Rd DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS -PERMIT AND CERTIFICATE OF COMPLETION
'Note: Issued in Compliance with G.S. of North Carolina.,Chapter 130—Article 13c.
PermW Number
Name Date;' ,:` , `;
2429
Location
Subdivision Name Lot No. _ Sec. or Block No.
.Lot Sized - House Mobile Home I Business Speculation
No. BedroomssNo. Baths No. in Family
Garbage Disposal. YES ❑ NO p �
Specifications'for System--- -
Auto Dish Washer YES f NO ❑' . ku 'j
4 ,
Auto Wash Machine. YES N6-,E], 7`
Type Water Supply
`This permit Void if sewage system described below is not installed within.36 months from date of issue.
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Improvements permit by � �
'Contact.a representative of the Davie County Health Department•forlinal inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number: 70,4-634-5985.:'
Final Installation Diagram: £ System Installed by �–• '��
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Certificate of Completion i , ' \ ab li Date ri r – b D
"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 betaken as a guaranteethat.th'e system will function
satisfactorily for any given.period of time: 1!
DAME COUNTY HE DMI
PERC61 4ilbN ' ESS' n,$ULTS
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DAVIE COUNTY•HEALTH DEPARTMENT ,
• ENVIRONMENTAL HEALTH SECTION
P.O. BOX 57
MOCKSVILLE, N.C. 27028
(704). 634-5985 .
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STATEMENT FOR SEPTIC T NK IMPROVEMENTS PEWMITS AND/OR SITE ALUA IONSNAME
. � '
AbDRESS 01 ERMIT NO.
1,10
" BXPLANATIO14 OF C11ARG �
.wr I ,{a.
AMOUNT DUE e �"' . °"SANITARIAN
PLEASE REiMIT THE ABOVE AM0PNT"OE' RECEIPT OF THIS STATEI,1ENT. f
*NOTICE: Evaluation(sl) kcan not be completed,until payment is ,received. %'
Improvements .Pirmit(s) can not be' issued until payment is received. .
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71