1063 Rainbow Rd DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.S. of North Carolina Chapter 130-Article 13c.
Permit Number
Name 6 Date �— N 2 514
Location �S� �•tp L-9�D To �Ll3-t nj i3 ``J ��J L Z4—
Subdivision Name' Lot No. Sec. or Block No.
Lot Size House --Mobile Home _ Business Speculation
No. Bedrooms Y_T"No. Baths No. in Family
Garbage Disposal YES ❑ NO Spgcifications for System:
Auto Dish Washer YES ❑ NO 7D X / rx
Auto Wash Machine YES It NO ❑
Type Water Supply W
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
j
-
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 In
stallation Diagram: System Installed by
V
Jr—
Certificate of Completion Date —5-b
*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 G.S. of North Carolina Chapter 130—Article 13c.
_ Permit _Number
Name - - - Date
qty`, > �, r- -2�.�;. . ,i•'(l :? (_/rt i to'
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size House .Mobile Home -' Business Speculation
No. Bedrooms No. Baths No. in Family _
Garbage Disposal YES ❑ NO E] Specifications for System:
Auto Dish Washer YES ❑ NO p �;;
Auto Wash Machine YES p NO ❑
Type Water Supply
i
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
e,.
i I
y }
f
'• � ail.lf/'
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 7 l
'k ,f
4 -
/ J r
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 G.S. of North Carolina Chapter 130—Article 13c.
r _ Permit Number
C�
Name A-iz `( , �`�.S �'� Date
Location !, l4 fi r tj
�� '� � � �
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home —^�.�`r Business Speculation
No. Bedrooms _ No. Baths L' T No. in Family
Garbage Disposal YES ❑ NO 0 Specifications for System:
Auto Dish Washer YES ❑ -NO [fl
Auto Wash Machine ttYE��S p NO E]
Type Water Supply __—
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
t� L1t
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
-��AA .
Certificate of Completion Jl S-�' Date 5
*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.