2207 Farmington Rd - DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE:Issued in Compliance With Article 11 of G.S.Chapter 130a i
Sanitary Sewage Systems Permit Number
Name 24rer x2- Date `' N2 6059
Location :., : r 1�,.. - 71,
Subdivision Name Lot No. Sec. or Block No:
Lot Size House Mobile Home _ Business Speculation
No. Bedrooms c9, No. Baths _ Z _ No. in Family c5l—.
Garbage Disposal YES Q NO Specifications for System:
Auto Dish Washer YES Q NO Q- v
Auto Wash Machine YES ,E] NO D'
Type Water Supply _—
'This permit Vol" 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.
Improvements permit by /zwll
"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 _ Date Id
*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
t =% IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
rx NOTE:-issued in Compliance With Article 11 of G.S.Chapter 130a
Sanitary Sewage Systems Permit Number
^�% z- .4% '2 t1 Date 2 6u59 ,
:. Name��t _.._._ rm._. G- � ` ,j �=�— �'"�-�� N
Location1 ,r �/ ��r1
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 ❑ ho p' `
Auto Wash Machine 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.
Y
C
' \/
Aet
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
i
s
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. `