2027 Milling Rd .. 4�',ar,! '!t,K•.':n ..;i"v<:t �Y)'. Y^�yVilf+:,.s� ;t+`a1 ,.;�r� ::f, t .;.�"+.t t.. lg i.�,;. ,:,. �.,.�.
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
Named^W ;�- �zSm/1, Date N2
6634
Location '4-r`�
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home _ Business Speculation
No. Bedrooms No. Baths a /2 No. in Family__
Garbage Disposal YES ❑ NO Er Specifications for System:
Auto Dish Washer YES NO ❑
Auto Wash Ma:hive YES j NO ❑ C77
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.
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Improvements permit by —nS'
*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
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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 th tem ill function
j satisfactorily for any given period of.time. � _ �r�
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DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND .CERTIFICATE OF COMPLETION
*NOTEAssued in Compliance With Article 11 of G.S.Chapter 130a
Sanitary Sewage Systems Permit Number
Names 7�r- �� �/�7�%�� Date N2
N2
w.
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size (" House Mobile Home Business Speculation
No. Bedrooms No. Baths `a No. in Family
Garbage Disposal YES ❑ NO a Specifications for System:
Auto Dish Washer YES NO ❑
Auto Wash Ma shine YES NO ❑
Type Water Supply ae/L x')"
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.
t ( r)
1 Id
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I It
Improvements permit by _ ZZZ'-'.<z'
*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 704-634-5585. ;
Final Installation Diagram: System Installed by �Z
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