155 S M Whitt Dr ` \ 01 I {i
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
"NOTE: Issued in Compliance with GS: of North Carolina Chapter 130 Article 13c
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
Name ���� � L�� �._�h `S Date
Location k
Subdivision Name�� S�S R )2 \��Lot or� �0� � Block�Wck No. fie
S .
Lot Size House Mobile Home _�_ Business __ Speculation
No. Bedrooms 3 �No.,Baths, No. in Family` _
Garbage Disposal YES 2' NO'p h
.,Specifications for System: — lib X
Auto Dish Washer YES �y NO p , -
ii
Auto Wash Machine YES [ ' NO
Type Water Supply
y ,
"This permit Void if sewage system described below is not installed within,,36 months',from date of issue.
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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 S--
"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
.*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
Name \. �_ s.,�,� \ 1� �`��N. Date
Location 1-,
1 ��.� �• yew ti'F��Tt
C
Su—bdivision Name �\
�� C' ' Sear Block No.
Lot Size House Mobile Home _t,/ _ Business __ Speculation
No. Bedrooms —_ No.,Baths No. in Family
Garbage Disposal YES 2� NO ❑
..Specifications for System:._ � ..�a•�^ y
Auto Dish Washer YES V./ NO p ' �
Auto Wash Machine YES ( ' NO p dot ,
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
*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 I
ED
0;Z_ f,
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. w