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- DAVIE COUNTY HEALTH DEPARTMENT
w _ IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
'NOTE:Issued in Compliance With Article II of G.S.Chapter 130a
Sanitary Se. age Systems Permit 6902,
Numbr�er
Name v" ljPr �cQ v��� Date q—/d -9� NO V 9 O G
Location 6� ' ! �. �,6 iiY/J� //��trr I A0`_
Subdivision Name Lot No. Sec. or Block No.
Lot' Size �� C House Mobile Home _T Business _ Speculation
No. Bedrooms No. Baths _ No. in Family
Garbage Disposal YES ❑ NO.❑ Specifications for System:
Auto Dish Washer YES ❑ NO ❑
Auto Wash Ma shine YES ❑ NO ❑
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 intended use change.
yjq-����a3ga
t
LLu%L
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
R .
n
Certificate of Completion �_ _ Date lam° /S F29—
The-signing
29The 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. v .-rte—,y .ii ,-ti ... :-- a .ii; ,r`z 'f MC.(. •a 't Eur .. >:"i� '�d e- ,.. .. _�:., - x .1 .1 r;':4•, cv..�'/J:,� r•{/').�,
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND, CERTIFICATE OF COMPLETIONa;
-'*NOTE:Issued in Compliance With Article 11 of G.S.Chapter 130a #
Sanitary
geJSystems Permit Number
~Name ,%iF%( °��/SO�i fT>cX��O Date N2 V 9.02
Location .'ff�fr✓ 1,�� �`
Subdivision Name Lot No. Sec. or Block No.
Lot Size Y r1 House Mobile Home Business __ Speculation
No. Bedrooms No. Baths No. in Family _
Garbage Disposal YES ❑ NO ❑ Specifications for System:
Auto Dish Washer YES ❑ NO ❑ -� �/ l J "i , ,�},
Auto Wash Ma:hive YES [:] NO ❑ X
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 intended use change.
i
Improvements permit by -- —L
*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.
Fin'al'tn tallation Diagram: System Installed -r-
1--
1 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: