415 Merrells Lake Rd (2) -^+T<9:�' ..0 r '.f C" ♦-:d'r� .iv.Kt�,..�'T.. ��� 4o'r 1:�t'�+.". ..i- i. ..... s a' •: ....ti r . (i'':
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DAVIE COUNTY HEALTH DEPARTMENT
1 IMPROVEMENTS PERMIT AND .CERTIFICATE OF COMPLETION
*NOTE:Issued in Compliance With Article 11 of G.S.Chapter 130
Sanitary Sewage Systems �j�,��� _:._ Permit Number
Name ( -1 / Date - �/ 0
N- 6600
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home Business Speculation
No. Bedrooms .No. Baths _ No. in Family __
Garbage Disposal YES ❑ NO p--
Specifications for System:
Auto Dish Washer YES NO ❑ v c�
Auto Wash Ma.hine YES NO ❑ ���1 �a
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.
f
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
Certificate of Completion � a � Date
The signing of this certificate shall indicate that the system described abovehas 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.
v !0
DAVIE COUNTY HEALTH DEPARTMENT
- - IMPROVEMENTS PERMIT AND .CERTIFICATE OF COMPLETION
rr; _*NOTE:Issued in Compliance With Article 11 of G.S.Chapter 130
Sanitary Sewage Systems fir,��e Permit. Number
Name_�' � �°i/�=r' z��✓j'�. ,� Date !!!V �?- / N2
6600
Location
J—`
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home Business Speculation
No. Bedrooms No. Baths No. in Family
Garbage Disposal YES ❑ NO p--' Specifications for System:
Auto Dish Washer. YES NO ❑
Auto Wash Ma thine YES Qi NO ❑ %� X
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.
`I
A
i
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.
t
Final Installation Diagram: Syste}rR,'Ins66d by
4. t-
q
p' f
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.