549 Sain Rd ... . :.y„az,e'.r: .as.-.7.,,s. .. y w.+_;�:xt,x,J4oat:�:,•'�a+b' .. 7s;,,<.,;-;. r.:.a^s , ., _,.�:: cm,.,s ,.» 4 4 i e = .. r: ..,. , i w
S DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMWAND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatmentand Dis osaI Rules (10 NCAC 10A .1934-.1968) Permit Number
Name v / �. .7 ", � Date 1/-� N� 473
Locatio
Subdivision Name Lot No. Sec. or Block No.
Lot Size HouseMobile Home _ Business Speculation
No. Bedrooms No. Baths No. in Family_
Garbage Disposal YES fl NO .lam Specifications for System:
Auto Dish Washer YES NO ❑ _
Auto Wash Machine YES NO ❑ S ,t'�,�r J 6� ��
Type Water Supply _
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
J-
d
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
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.
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DAVIE COUNTYHEALTH- DEPARTMENT
IMPROVEMENTS PERMIT AND ;CERTIFICATE OF COMPLETION
`NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
i Sewage Treatment and Disposal Rules (10 NCAC 1 O .1934-.1968) Permit Number
Name -?�.: r9-;� % �'�r'.� rf`.,%/� Date %r;/{ N0 5473
Locatio Jr 7 '� 3 _ /� 1�rI/'° /!� %� 1 r� /'Yf: it d`s/ f' ie f i •r 1y /si ^�
tt ,
Subdivision Name Lot No. - Sec.'�or Block No.
Lot Size House4..r_—" obile Home _ Business t' Speculation
No.yBedrooms No. Baths _22 No. in Family !Z:t
Garbage Disposal YES p NO p Specifications for System:
Auto Dish Washer YES NO ❑ _ _ ;,.
Auto Wash'Machine YES NO ❑
Type Water Supply --
*This permit Void if sewage system described below is not installed within 36 months from date of issue. y
t -
IL
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
JIlk� r
� f
w.,
Certificate of Completion ��--. �� Date y'Vj
"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.