481 Riverdale Rd (2) DAVIE COUNTY HEALTH DEPARTMENT
� nh- s IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION�) *NOTE:Issued in Compliance With Article I I of G.S.Chapter 130a
Sanitary Sewa a Systems Permit Number
Name J 61PW-;-xV,, Date a "g� N2 6160
iPkra/ NDN �7oys
Location _
em , �
Subdivision Name Lot No. Sec. or Block No.
Lot Size � 1/ e Housey� Mobile Home _ Business Speculation
No. Bedrooms No. BathsNo. in Family�_—
Garbage Disposal YES ❑ NO l/ Specifications for System:
Auto Dish Washer YES ❑ NO 2r
Auto Wash Machine YES ❑ NO
Type Water Supply --- ,S`O
*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.
Y
- 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. or 1:00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram: System Installed by IS�4 A,'Y//2�
Certificate of Completion _ �L/� 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.
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DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
-77
til *NOTE:Issued in Compliance With Article II of G.S.Chapter 130a
Sanitary Sewage Systems Permit. Number
Name //�r> w�,cs' r,JC/,1, 1-4,A,in- 61- Date !Z No 6160
Location
le
Subdivision Name Lot No. Sec. or Block No.
Lot Size=,/�/ L Housey Mobile Home Business Speculation
No. Bedrooms - / No. Baths / No. in Family, _—
Garbage Disposal YES ❑ NO [,r Specifications for System:
Auto Dish Washer YES ❑ NO p' //5
Auto Wash Machine YES ❑ NO pj '' vrf1
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. ;
Y
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. or 1:00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram: System Installed by
)J-6
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.