1738 Junction Rd (2),,. ,i•... -. ,.1._:.-µ,:T.z.--q—F(]1�,`za .,.«:•: y..,..{,j ;;. :r• ci _ -z. - t ., .. - .. - .. .. -.. ..- - - __. - .. -.
�1f 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 �.�� �( i/Jl�/ — Date —� N2 5247
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home _ Business Speculation
No. Bedrooms 3 No. Baths - No. in Family
Garbage Disposal YES p NO 21' Specifications for System:
Auto Dish Washer YES � NO
Auto Wash Machine YES NO p
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 m��nIhs fro date of issue.
i
I�0i
Improvement permit by
*Contact a representative of the Davie County Health Department for inal inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Num er: 704-634-5985.
Final Installation Diagram: System Inst led by
U
Certificate of Completion _7� C-�C� 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.
M:r `y+'vx• .3• i-4r b+..1.. ":p s ,:,.,:3 t:*�'W.L� I'..r F'-i.tt 1 'M:�.1 _y t t' 6F'r ti• i. w , .. A 1 : .. :.. SJr.., .. .....' YOP tr 7 ..
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
7'aI,OTE-�-fssued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage•Tr6atment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
�,
Name
Date ,
Location
� f
t
Subdivision Name Lot No. Sec. or Block No.
Lot Size House l/ Mobile Home _ Business Speculation
No. Bedrooms No. Baths___ __ No. in Family
Garbage Disposal YES p NO p- Specifications for System:
Auto Dish Washer YES NO
Auto Wash Machine. YES I NO
Type Water Supply _
*This permit Void if sewage system described below is not installed within 36 months fr date of issue.
1
f
Improvemen permit by _
*Contact a representative of the Davie County Health Department for knal inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Num er: 704-634-5985.
Final Installation Diagram: System Inst Iled by
1
i .
Certificate of Completion f� !'!�',r 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.