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269 Fork Bixby Rd . a -i .- • I . t - :.4` 1• r. r r� a•t , v -+r. .r'y fT. r. _, ,'.L. .. �� �(�•�S /xo �` DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND .CERTIFICATE OF COMPLETION *NOTE:Issued in Compliance With Article II of G.S.Chapter 130a Sanitary S jwage Syste ns, Permit Number Name ate N2 6762- 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 ❑ Specifications for System: Auto Dish Washer. YES ❑ NO ❑ Auto Wash Ma thine YES E] NO E] Type .Water Supply __— *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 or the intend d use change. a a >` Improvements permit by *Contact a representative of the Davie County Health Department for final inspection of this system between 8:3D- 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 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. �? -DAVIE COUNTY HEALTH DEPARTMENT • � ` - IMPROVEMENTS PERMIT AND .CERTIFICATE OF COMPLETION *NOTE:Issued in Compliance With Article II of G.S.Chapter 130a -sanitary Sewage Systems1� 1� _ r Permit Number Name .I7if��, �yz,"�� GYx � :_,` i �. Date f� NO i - 67 Location/ Subdivision Name Lot No. Sec. or Block No. Lot Size House Mobile Home __. Business Speculation No. Bedrooms A� No. Baths / No. in Family Garbage Disposal YES ❑ NO ❑ Specifications for System: Auto Dish Washer YES ❑ NO ❑ Auto Wash Ma shine YES ❑ NO ❑ ��1 `� `'�J -- ' Type Water Supply *This permit Void if sewage system described below is not installed within 5 years from date of issuer - This permit is subject to revocation if site plans or the intended use change, 0 E� r 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 Certificate of Completion _ 6/// 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.