583 Eatons Church Rd DAVIE COUNTY HEALTH DEPARTMENT r�
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE:Issued in Compliance With Article 11 of G.S.Chapter 130a
Sanitary Sewage Systems q Permit Number.
Name T N P'P� Date —L / N2 6247
Location0.
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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 Q.. NO V Specifications for System: -
Auto Dish Washer YES p"' NO [i
Auto Wash Machine YES"M,' NO ❑
Type Water Supply
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*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.
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C) ' y Improvements permit by
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*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- ter
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.
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DAVIE COUNTY HEALTH DEPARTMENT
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IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION "'
NOTE:Issued in Compliance WitgiAriicle I I of G.S.Chapter 130a
Sanitary Sewage Syste�mcs- q Permit Number
,-Na � �"��� <- = 1. �'t� t �� Date r f NO 6247
Location � ��` • s �e�Cr'Gat �T _ o• s v.
•�«;=7� �� � \�` RC's �..,L�'Cs_����� / � '•:�S,A- �.� 8'C\.�'a -�.��.�.d� ,` !>.\,tC` ,�� �"'U ,��, �.r+ aJ�
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home _ Business Speculation
No Bedrooms No, Baths` 2 No. in Family ,
Garbage Disposal YES p NO 2-.. Specifications for System: A
Auto.Dish Washer YES [p' NO,p
Auto Wash Machine . YES 'p/ NO p
.� r. ) r
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.
r
r-•
q
Improvements permit
*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 � 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.