155 Calahaln Rd (2) DAVIE COUNTY HEALTH DEPARTMENT ' �d
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
Name�(J'i/. Date N2 5427
Location e5r`/! - j➢' /, /!'`l��a_r, Z ,/e
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i�� •";'✓ rte/"(y;r Y.�iL��
Subdivision Name Lot No. Sec. or Block No.
Lot Size House «� Mobile Home Business Speculation
No. Bedrooms 3 No. Baths No. in Family _
Garbage Disposal YES ❑ NO ❑ S ecificl� for System:
Auto Dish Washer YES E] NO C] �j �s-��ja
Auto Wash Machine YES ❑ . NO C] �J
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
1 j
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Improvements permit by
*Contact a representative of the avie 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
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Certificate of Completion Date" �tj1
101,
*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 -
a
IMMOVEMENTS PERMIT.AND AND CERTIFICATE OF COMPLETION
"R&E: sued-in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-./1968) Pe�1111t Nlliflbet'
' NarrteN/ Date '1i� Y N2 5427
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 '❑ S ecifica ' for System:
Auto Dish Washer YES p NO ❑
Auto Wash Machine YES ❑= NOS'0
Type Water Supply
—
,This
LI;
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
141
UY �
1 4 !
Improvements permit by
*Contact a representative of the avie 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
l
i
U
14;7
Certificate of Completion tate
'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.