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P5613 Cornatzer Rd 44 DAVIE COUNTY HEALTH DEPARTMENT 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 ^ � - p Name \`\�R Q ��, C�� S Date Wq N2 613 Location C rC� ��X � b��L�� a 1Z_, Subdivision Name Lot No. Sec. or Block No. Lot Size +� ' House �'� Mobile Home — Business ' I t Speculation No. Bedrooms No.Baths ^ 1 No. in Family" LA Garbage Disposal YES p NO .Q/ , 2 0",N0 Specifications for System: c'l� Auto Dish Washer YES ©' 1 Auto Wash Machine YES NO Type Water Supply *This permit Void if sewage system described below,is not installed within 36 months'from date of issue. 1�1 U A _ _.. 'DO 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 L Certificate of Completion p Date *The signing of this certificate shall indicate that the system describ d 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. ,•, s•;,r.,, a a� ,r .,,;-...y .q.:y:s..w--.. �.*x- �-^pv::t,iaw5 y�"�:5u1. w, �:r-ui' .o•�<'" u, t t... • - +�..'+,,,iia tv;'a i`..t.,:-' _, ., � � + �- t v. DAVIE COUNTY HEALTH DEPARTMENT d, IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION t •'NOTE:'tissued in Compliance with G.S. of North Carolina Chapter 130 Article= 13c � Sewage Treatment and Disposal Rules (1d NCAC 10A .1934-.1968) Permit Number ,F Name �\p. � �\ '�: c� S Date NO;, Location Subdivision Name Lot No. Seo. or Block No. Lot Size r'/ �- House Mobile Home Business Speculation 4? No. Bedrooms No Baths " 1 No. in Family Garbage Disposal YES ❑ : NO E3/ P y , S ecifications°for System: Auto Dish Washer YES ❑ NO Q' Auto Wash Machine YES` NO ❑ CjC, Type Water Supply ¢ *This permit Void if sewage system described below.is not installed within 36 months from dat6 of issue. jl C P 1 - ........................ Improvements permit byti_a�`�sti� -r. 1y-`� *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 Certificate of Completion Date fl � *The signing of this certificate shall indicate that the system describ d 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.