351 Richie Rd '✓q'Y..'Y+. yv ..:''x�yp �1:v3 r,. ., :.t, S. :...y q, , u'.. x ;. �r Nib ; eey a� .. -
K " Vat iyi r it ;cti� ,� r ' tt l�r", •T�{' {4:p�tll x *,Ft 4�r. }P
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DAME COUNTY HEALTH DEPARTMENT
I' IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE:Issued in Compliance With Article I I of G.S.Chapter 130a
Sanitary Sewage Systems Permit Number
Name_ 411 /w, �E Date / �'q� N27420
4�G Q
Location 7' - �/yl.� �.� �Z �'�� la_re° dy. i9 "Da
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home._ Business-- Industry
No. Bedrooms No. Baths _/__ No. in Family Public Assembly Other
Garbage Disposal YES (:3 ❑
NO '
e Specifications for System: �/1 ,pp
Auto Dish Washer YES ❑ NO ❑ lv �J
Auto Wash Ma:hive YES ❑ NO ❑ �w v i, f
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.
'4
J
S
r
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.,
1:00-1:30 P.M.or 4:30-5:00 P.M.on day-of completion.Telephone Number:704-634-5985.
Final Installation Diagram: System Installed by 0&_Zg!� e"
Certificate of Completion Date ZLlzi L
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
'NOTE:IssUbd in Compliance With Article I I of G.S.Chapter 130a
-Sanitary Sewage Systems Permit-Number
Name Aa leDate -YY N27 4 2 0
/ ' fr.,
Location d& 'X � ", `d l212 �� r� p , Idfllf Q,✓ SLI sir>S�
'
Su�bdi-vissiion Name Lot No. Sec. or Block No.
Lot Size}� House _`Mobile Home _ Business Industry
No. Bedrooms .—.No. Baths No. in,Family _ Public Assembly Other
Garbage Disposal YES ❑ NO E�-
Specifications for System:
Auto'Dish Washer YES ❑ NO ❑
Auto Wash Ma thine YES ❑ NO ❑ ioa
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.
So
Improvements permit by1! -
*Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M.,
1:00-1:30 P.M.or 4:30-5:00 P.M.on day of completion.Telephone Number:704634-5985.
Final Installation Diagram: System Installed by (�Nw 'e"
Jr
EJ
yD
Certificate of Completion Y 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 functio
satisfactorily for any given period of time. 1