164 Joe Rd '�J� ° arti r+r , .#};y,"xta.p�"�yti"tyrEjjL'F'�°'ai"`�i�Fw :�*trv+j' "Yi�l:div+ti>Dy bit '�a`r cf�`s, -, y, ,k4�+rr4r�♦ 4'�'"mr j' `� atti t_rvr`,'rrnk7�a.. `"
X DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE:Issued,in,Compliance With Article I I of G.S.Chapter 130a -
Sanitary Sewage Systems Permit/Number
Name t�L/Date _�1 N2 7 4 4 7
Locations
Subdivision Name Lot No. Sec. or Block No.
Lot Size House lz / Mobile Home _T Business Industry
No. Bedrooms Baths Z No. in Family_ _ Public Assembly Other
Garbage Disposal YES p NO ( Yy: Specifications for System:
Auto Dish Washer YES NO p �j
Auto Wash Ma thine YES L'J NO p s
Type Water Supply
*This permit Void if sewage system described beloWis not installed within Syears from date of issue.
This permit is subject to revocation if site plans or the,iritended use change.
pkv, M1�e;"�l
i
s»
3
Improvements permit b
P Y
*Contact a represen ative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M.,
1:00-1:30 P.M.or 4:30-5:00 P.M.on day of completion.Telephone Number:704-634-5985.
Final Installation Diagram: System Installed by vAe& 04,
�5
Certificate of Completion _ s+J �_ 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.
.• „ ^ DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND' CERTIFICATE+OF COMPLETION
N'0'1-t-Issued in Compliance With Article I I of G.S.Chapter 130a
"'Sanitary Sewage Systems Permit Number
Name Date Z:` 7447
Cx
o ,
cation .�� 7` �! � T
Subdivision'Name Lot No. Sec. or Block No.
Lot Size House Mobile Home Business __ industry
No: Bedrooms— `-`No. Baths — — No. in Family_L_77:`1 Public Assembly Other
Garbage Disposal YES ❑ NO 2--- Specif ations for System:
Auto Dish Washer YES 4 NO ❑ �/
Auto Wash Ma thine YES [rj NO ❑ /� �i
Type Water Supply, NIN--- ���y
'This permit Void if sewage system described below iskh.ot Valled withiri'5'years from date of issue.
This permit is subject to revocation if site plans or 7t\� the` mend d use change.
- =- S--
11
�.. : !o
r ,
Improvements permit bY
*Contact a represen a i e '6e Davie County Health Department for final inspection of this system between 8:30-9:30 A.M.,
1:00-1:30 P.M.or 4:30-5:00 P.M.on day of completion.Telephone Number:704-634-5985.
Final Installation Diagram: System Installed by v
r
s
Certificate of Completion Date f7/"X
'The signing of this certificate shall indicate that the system_described above has bae& 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.