466 Calahaln Rd DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE:Issued in Compliance With Article 11 of G.S.Chapter 130a
�Sanitary Sewage Systems Permit Number
Name \(S Dated T :6148
Location
,
W
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 pt: NO ry Specificati ns Sys
f tem:.,.
A
Auto Dish Washer YES`°❑ NO p'
Auto Wash Machine YES p' NO -00\ ki 3 1.� i a►i S �Z_
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
t i
4
�a
f`
t' Improvements permit by
*Contact a representative of the Davie CountyHealth 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 _•e'er 0-a ,
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.
i p3,a, ..,,, ,�,ri•� DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION—.;e
- !a
*NOTE:Issued in Compliance With Article 11 of G.S.Chapter 130a j
1Sanitary Sewage Systems Permit Number
-14ame��� �` �> 1 < Date 0�
Location .
Subdivision Name --- Lot No. Sec. or Block No.
Lot Size � . House Mobile Home
'� Bness „Speculation
No. Bedrooms No. Baths No..in'Family
Garbage Disposal " YES ❑ NO -,
g p ;,-� � ,� � Sph
ecificati t4for• System:. N6o-',�
''-
Auto Dish Wss4r YES`❑ NO
Auto Wash Machine YES NO , Oo
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
J
t� �
8
w
t
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 by11C LI22,1 OZ611-4
Certificate of Completion __ Date ^ 7�:
*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.