1972 Hwy 801S (2) DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
"`NOTE: Issued in Compliance with G.S: of North Carolina. Chapter 1,30 Article 13c2�CLfiL
Sewage Treatment.and Disposal Rules (10 NCAC 10A .1934-.1968) - Permit Number
Name
Location .
Subdivision Name Lot No. Sec. or Block No.
Lot Size House �-f f Mobile Home Business _— Speculation
No. Bedrooms !— No. Baths —f, No. in Family A� —
Garbage Disposal YES ❑ NO p-' Specifications for .System: ,
Auto Dish Washer YES NO ❑ 1 %. ,
Auto Wash Machine YES NO ❑ rS�y,�'/��' /�
Type Water Supply __ .��-'<�%%
YP pp Y —
*Thi! permit Void if sewage system e,scribed'below is not installed within 36 months from date of issue.
s=�
01
i
iF
Improvements permit by 4
`Contact a representative of the Davie County Health Department for final inspection of this system between
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
Certificate of CompletionDate
'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.