P2748 Prison Camp Rd DAVIE COUNTY HEALTH DEPARTMENT
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-IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name Date P.8
Location I';z�,oN Cn r i �. t'1t �'�� , :,N r �I-- �' 1'j I�
Subdivision Name Lot No. Sec. or Block No.
Lot Size 4 House '-'� Mobile Home — Business Speculation
No. Bedrooms 3 No. Baths �- No. in Family qoo 1�S.
Garbage Disposal YES-0 NO p� Specifications for System::i__�5'0r1C//0fj i41�-
Auto Dish Washer YES ] NO
Auto Wash Machine YES Q] NO 'z� � rV� Z c) ;K 3
Type Water Supply 60`J' --- `,�� t o,z �,--� co rjc/t c-1C
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
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.,
i
i'
Certificate of CompletioDate
*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 i N way be taken as a guarantee that the system will function
satisfactorily for any given period of time.