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889 Howardtown Rd (2) rah;'.--.... ;,.`<.,. f. .�•.i'{� ic'': <+a.v..-Rw-��:'i .t3 w�'.1h `a , ,=.r-1,i,_` - DAVIE COUNTY HEALTH DEPARTMENT _ IMPROVEMENTS PERMIT AND .CERTIFICATE OF COMPLETION *NOTE:Issued in Compliance With Article 11 of G.S.Chapter 130a Sanitary Sewage Systems ~-� Permit Number Name �,�e"�C� If ?NO 51 Date c -�- 9 I N° 64-59- Location L� Subdivision Name ` C�` Lot No. Sec. or Block No. Lot Size House Mobile Home _T Business Speculation No..Bedrooms No: Baths No. in Family SL _ Garbage Disposal YES ❑ NO.p' z , Specifications for System:. Auto Dish Washer. YES NO ❑ Auto Wash Ma shine' YES ©� NO ;s 0 Type Water Supply Cb • �v :=R _ *This permit Void if sewage system,described below is not installed within 5 years from date of issue. This permit is subject to revocation if site plans;ors.the intended use change. ' f I ; R --r jJ ,r o 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 � — lV Certificate of Completion D _ Date C '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. -fr -+� . 1 L•� ... t O DAVIE COUNTY HEALTH DEPARTMENT ..f IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION ,*NOTE:Issued in Compliance With Article II of G.S.Chapter 130a -SanitarySewage Systems Permit .Number Name �� c�c?�" u�r �'"�' 0 Date _ I N0 6459- o 459 �t� �-�s1?•a. cYt- 511 V �.__---- ----''- Subdivision Name c, Lot No. Sec. or Block No. Lot Size House V Mobile Home _ Business _ Speculation 'No. Bedrooms n No. Baths , No. in Family Garbage Disposal YES,❑ NO p' Specifications for System: Auto Dish Washer. YES OOH NO p Auto Wash Ma.hine YES p . NO Type Water Supply �Z - *Thispermit Void if sewage system described below is not installed within 5 years from date of issue. This permit is subject to revocation if site plans orthe intended use change. 1. O F 1 _ P P nU t f 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 f 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. _. r WORKSHEET FOR SEPTIC 'SYSTEM REPAIR PERMIT NAME ° PHONE NUMBER �j try ADDRESS �`� g SUBDIVISION NAME SUBDIVISION LOT# DIRECTIONS TO SITE to 4 DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER SPECIFY PROBLEMS OCCURRING DATE REQUESTED -7 I 51 INFORMATION TAKEN BY