162 Murphy Rd -�,.t _j 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 q Permit Number
Name ,D' o w e�S Date `�- 5 - / N2 5987
Location YL*�°
Wt
Subdivision Name Lot No. Sec. or Block No.
Lot Size" House' Mobile Home _ Business Speculation
No. Bedrooms — No. Baths .. No. in Family
Garbage Disposal, ,:4 YES p NO E( Specifications for System:
Auto Dish Washer— YES p� NO ❑
Auto Wash Machine YES p� NO ❑ J 00 X 3 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.
0
r
k�C� loA ' G 1d
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-- ° L)
S
d W
4
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.
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
4
*NOTE:Issued'in.Cgfnpliance With Article 11 of G.S.Chapter 130a
Sanitary Sewlarge Systems q Permit Number
NameE_ 1 o wqe�_� Date 5 1 NO 59,87
Location
o�t 2 ) l o C_ j A\91 _ 4
�a O 1
Sub)ivision Name Lot No. Sec. or Block No.
LoCSize C,-r House. Mobile Home _ Business Speculation
No. Bedrooms 'No. Baths— -� No.in Family. _
"Garbage Disposal YES [] NO 21-,
Specifications for.System:
Auto Dish WasherYES NO Ej
Auto Wash Machine YES'L3J NO p
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.
0
f
r;
kJoy ' o td
tj
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
4
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.