2039 Milling Rd l
DAVIE COUNTY HEALTH DEPARTMENT .
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE:Issugd in Compliance With Article 11 of G.S.Chapter 130a
Sanitary Sewage Systems Permit Number
Name Date ��S�Ql> N2 6158
Location :r� -•� >" FP�I� ,.nn �� .�d
Subdivision Name / Lot No. Sec. or Block No.
Lot Size House y Mobile Home _ Business Speculation
No. Bedrooms No. Baths No. in Family _
Garbage Disposal YES ❑ NO E�t' Specifications for System:
Auto Dish Washer YESNO F-1Auto Wash Machine YES [j NO ❑ Or-
�'X,,2
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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fro b 1 PrA
a
10C
Improvements permit by A A//
*Contact a representative of the Davie County Health Department foe 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 //� f 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..
DAVI E
COUNTY HEALTH DEPARTMENT.
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
NOTE`I sued in Compliance With Article I I of G.S.Chapter 130a
GSanitary Sewage Systems Permit Number
Name ,rr� �'f.,> `'7I✓��� Date N2
11
N2 6`� 5 3
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 [ Specifications for System:
Auto Dish Washer YES NO11
❑
Auto Wash Machine YES NO ❑
Type Water Supply _ !
*This permit Void if sewage system described below isnot installed within 5 years from date bf issue.
This permit is subject to revocation if site plans or the intendesi use change.
l�`
�'If
a
1
Improvements permit by �l d
'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 /��; �'/ Date !fr
"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 rI
satisfactorily for any given period of time.