132 Becktown Rd (2) DAVIE COUNTY HEALTH DEPARTMENT
c l k, IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOT Issued in Compliance With Article I I of G.S.Chapter 130a -
iwo( Sanitary Sewage Sys ems Permit Number
Name /tel �l�a d y. ' Date _f N° 7 5 5 9
Location
A2 1'� -
Subdivision Name Lot No. Sec. or Block No.
Lot Size ���-- House _, Mobile Home _� Business Industry
No. Bedrooms No. Baths No. in Family� Public Assembly Other
Garbage Disposal YES p NO 2- Specifications for System:
Auto Dish Washer YES NO E] 69 ')0
Auto Wash Ma-.hine YES NO
Type Water Supply
*This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change. _
all
Improvements permit by —_'e4Q1
*Contact a representative 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 CoalsaZ44k
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Certificate of Completion 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. :r