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7453 Hwy 801S w'a cr--sur -r ©y ✓ 4 DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE:Issued in Compliance With Article 11 of G.S.Chapter 130a Sanitary Sewage Systems Permit Number Name J'� r� �-S�l oo F�1iEbate —.�—�-�� No 6898 71 Location N �� l� /tirO"1 Subdivision Name Lot No. Sec. or Block.No. Lot Size House �^ Mobile Home _T Business __ Speculation No. Bedrooms No. Baths _ ;t No. in Family Garbage Disposal YES p NO Specifications for System: Auto Dish Washer YES NO p .� 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. �6 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 _WAV4J J. r o'O b r Certificate of Completion Date *The signing of this certificate shall indicate that.the system,Aescribed above has been installed in compliance with the standards set forth in the above regulation, but shall in. O way be taken as a guarantee that the system will function satisfactorily for any given period of time. dr r �:i Mei:.Ft r ,_ -w-..�.�'i,+.45i.J..'`-�,•' _. _ ,. 5.r...,Y`s "q`xfi� .°-i.•� -st :t-... -r: c` Pr .F DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION -'NOTE:issued in Compliance With Article II of G.S.Chapter 130a SanitarySewage Systems Permit Number Name,, //.'`1 ` �' i�G` GSA ; <i/mac Date —1 N0, 6898 Location / gid ��'• % � � _ c� .. ��: , Subdivision Name Lot No. Sec. or Block No. Lot Size House '' Mobile Home _T Business Speculation No. Bedrooms No. Baths — �2 — No. in Family _ Garbage Disposal YES ❑ NO ET, Specifications for System: Auto Dish Washer YES W NO E)Auto Wash Ma shine YES NO ❑ � �Z1 -S�/Y� = Type Water Supply 'This permit Void if sewage system described below is note installed within 5 years from date of issue. This permit is subject to revocation if site plans or the intended use change. J-D t' - 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 —&X?nk - - U t7 6 • r Certificate of Completion �U✓!� 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.