338 Foster Rd .rt-.i.l...f- '.air':<:..i. _._._:.,_ v-♦-.... .♦. ._. _ _-, -..': . a...-. .::` • ♦ -. ..
AN
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c t
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.19681 Permit Number
Name f Gr �� / Date / N2 5689
Location 4L/ /F,07_ If",' - c A/ 'x� - V=— Z /rte 1,<,��/Jl��ll�
Or✓
Subdivision Name Lot No. Sec. or Block No.
Lot Size /by e House Mobile Home _ Business Speculation
No. Bedrooms No. Baths No. in Family
Garbage Disposal YES fl NO p— Specifications for System:
Auto Dish Washer YES ❑ NO Er-'
Auto Wash Machine YES ❑ NO
Type Water Supply
*This permit Void if sewage system described below is not installed within 6 months from date of issue.
Improvements permit bY
i
*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 Iled by
t
CD
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Certificate of Completion G 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.
t..�'�'� n .'i'�.; s a:.s u T•. y..-�:..^'.� Jrvys._;�r.t"..i:`i,+' . i' ! � i 1 { ..,. ,. E--' et} , -. -. „f .. ..':s ,F'�i._
_ DAVIE COUNTY',JAJI-I DEPARTMENT f
w' 'IMPROVEMENTS PERMIT AND CERTIFICATE:,OF COMPLETION j
TE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
'Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) �r P@rmlt; h1imber
- Name �J��i(/, V)/d�r��% �7`�/�l��Sd,/� Date // r N2 5 U 8 Q
� v
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 [—r' Specifications for System:
Auto Dish Washer YES ❑ NO
Auto Wash Machine YES ❑ NO
Type Water Supply 1
*This permit Void if sewage system described below is no installed within 6 months from date of issue.
s
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 n lied by
l�--��,X�4V
1 . ,
Certificate of Completion / 1 l Date S/�
*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.