P7380 Hearthside Ln 1 DAVIE COUNTY HEALTH DEPARTMENT 160.M
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- IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
'NOTE:Issued in Compliance With Article II of G.S.Chapter 130a
Sanitary, swage System Permit Number
Name amts 3 os ar Date "�� N' 7380
Location ' " \ � 00 _ �-\�V P N c o ` ,e �Ll 0 U b
SubdivisiYN Lo't No. Sec. or Block No.
Lot Size 5 V'r3 House Mobile Home Business !_ Industry
No. Bedrooms 't.No. Baths _ —_ No. in Family _ Publio As embly Other
Garbage Disposal YES 0 NO Sp cificatlons for System:
Auto Dish Washer . YES.,e NO p
Auto Wash Ma shine YES ( NO ,0
Type ti'Vatcr supply
'This permit Void if sewage'system'oescribed below is not installed within 5 years from date of issue.
This permit is subjept to revocation if site plans or the intended use change. :
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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.,
1:00.1:30 P.M.or 4:30-5:00 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 indicato 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.