1554 Ridge Rd ....,v.---,w: ,a.r_�...:��.-w. :.v+�,P'.".p�"'�vti.ji•'rrR:+rs»;aW^Zat+'°L'?Y7' `"'° �.+�"�..'cl.7kv'+tl"4`iiY' .s•_-•'-v:^+y.--.s..�—.. ..-��_. .y,,,�C;�—'sA TPP
DAVIE COUNTY HEALTH DEPARTMENT
;yr IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION 5 0' 0i1
*NOTE:Issued in Compliance With Article I I of G.S.Chapter 130a
Sanftqry�ewage�Systern a R -1 L1 _ Permit„[drier
Name Date NO
Location �� � � 3�3 �o��s v ,��Q . t � •�. ���a6
Subdivision Name Lot No. Sec. or Block No.
Lot Size House l' Mobile Home _�_ Business Speculation
No. Bedrooms No. Baths No. in Family —
Garbage Disposal YES ❑ NO �j Specifications for System: 'vr.
Auto Dish Washer ' YES NO
Auto Wash,Ma.hine YES '(!f NO ❑ X x
Type Water Supplyti =
*This permit Void if sewage system described below is not instaliedUithin 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
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Improvements permit by -- _
*Contact a representative of the Davie County Health Department for final inspection of this system between 8:307
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
IV
Sa l�d
�rUe a ti��
0
n A� Oon
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
*NOTE:Issued in Compliance With Article II of G.S.Chapter 130a -.
Sanitary Sewage Systems'?-) Permit Number
Name V, `- Date �, .. N2 6863
Location y` \ � _"` '' �� � � - � �
Subdivision Name Lot No. Sec. or Block No.
Lot Size " t+ House Mobile Home _T Business -- Speculation
No. Bedrooms No. Baths No. in Family —
Garbage Disposal YES ❑ NO Er Specifications for System:
Auto Dish Washer YES ❑ NO Rr _
Auto Wash Ma shine YES [a NO ❑ � j
Type Water Supply . UQ Jk ---
*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.
Il t7 � V 4'
y I
L'
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JJ
l`u
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 �
1 _
sand
A
tiG
Certificate of Completion Date 1A _
*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.
D.
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
• _WORKSHEET FOR SEPTIC SYSTEM REPAIR PERMIT u
NAME c'Z� �� V oya a., —PHONE NUMBER 41 ��" �^ T g'�
ADDRESS ?-) O-V4 3 �3 SUBDIVISION NAME
c S.
SUBDIVISION LOT#
DIRECTIONS TO SITE ` ` CTS N.�c d`� �� hk
DATE SYSTEM INSTALLED L h�
NAME SYSTEM INSTALLED UNDER
SPECIFY PROBLEMS OCCURRING ..
DATE REQUESTED -�3 ��' INFORMATION TAKEN BY •� -�.