P3209 Pudding Ridge Rd DAVIE COUNTY HEALTH DEPARTMENT
3'3a
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
`Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name Date -' <_ �
4..
r
Location ` F�,< ! �_r' t j I S , r IL• C'f C .
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 ❑ NO ❑ r A"���``~ , ' ti _ ,, j('
Auto Wash Machine YES p'l NO ❑
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
i
Improvements permit by r' `
*Contact a representative of the Davie County Healt Deprtm t for foal inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day of completion Tele hone r. 704-634-5985.
Final Installation Diagram: stem Installed by
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.
F DAVIE COUNTY HEALTH DEPARTMENT T
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note:Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name t, e (Z . Date 3 _ C
_ e-
Location1;?n.'��,� �« 1.�t , r r ?'tA fFr� �. �< Jr
Subdivision Name Lot•No. Sec. or Block No.
Lot Size House Mobile'Ho" 4 Business Speculation
No. Bedrooms No. Baths No. in F.,amily ,?-'
Garbage Disposal YES ❑ NO [2- Specifications for System:
Auto Dish Washer YES ❑ NO ❑ w- _ .,, x r z" ��, c j -
Auto Wash Machine YES p"l NO ❑ �'� �J t
Type Water Supply u.,c_1 t _ �� ,► ,.c. �'. ; s r ; . �,. 1:,h._
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
f-
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V
Improvements ements permit by
*Contact a representative of the Davie County Health Dep rtmOnt for final inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day of completion1 Telephone Nugt6er: 704-634-5985.
Final Installation Diagram: ���� S. stem Installed by ��—
Certificate of Completion r� F�-Q 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.