1805 Hwy 64E 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 .19347.1968) Permit .Number
Name Po6c.r Atleh Date 12= t t 44. N2 3762
Location i4 a".7 :. T:s S 4-VI
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 ❑ NO ❑ !
Auto Wash Machine -YES ❑. NO �❑
Type Water Supply N-ka Or b4
71
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
-
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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 _��� `t Fait
Certificate of CompletionDate
*The signing of this certificate shall indicate that the system described ove 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
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 Rn�� r �l t l c h Date 12 1 l -8 4 '37/ 62
Location :l r.c► 6, t 1r r i^f r— T `7.C e
Subdivision Name A 242a 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 ❑ NO ❑ r e e,
Auto Wash Machine YES E] NO F-115 R 3 Xi 2 /��K
Type Water Supply = Q _—
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
lve
d '
I �
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
C� -
C�'
Certificate of Completion S' Date f
*The signing of this certificate shall indicate that the system described Lve 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
*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 Date 1 2 - 1 1 - '`( b 3 u2
Location I•
Subdivision Name A 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 DishWasher YES ❑ NO ❑ _ ,
Auto Wash Machine YES E] NO ❑
Type Water Supply ('n _
1
'This permit Void if sewage system described below is not installed within 36 months from date of issue.
G �
Improvements permit by ! • T�� ="" �''
;1
'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
P
lam'_
Certificate of Completion Date I
"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.