179 Tatum Rd 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 .E�'� .•� r � <� Date N2 N2 6087
Location Vim! -- ✓ /�/4�.� � C'; r
CJ
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 ❑ Specifications for System:
.Auto Dish Washer YES ❑ NO ❑
Auto Wash Machine YES ❑ NO ❑ p2( yx y✓
Type Water Supply _
.*This permit Void if sewage system described below i� instal ed within 5 years from date of issue.
This permit is subject to revocation if site plans or the inte ded Ose change.
f7
z(1
z 1l .
G )
Improvemen ermit by
*Contact a representative of t e Davie County Health De artment for fins inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. day of completion. Te phone Number. 4-634-5985.
r
Q
Final Installation Diagram: $, System Installed b
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.
• a
DAVIE COUNTY HEALTH DEPARTMENT V b
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
NOTE:Issued in Compliance With Article 11 of G.S.Chapter 130a
" Sanitary Sewage Systems Permit Number
� meL —de-"22,;12 - 7 -�''r �✓O�l Date r .�. %� ' N2 6037
Location` .� I' �- i �`r .�',i� ,✓ ,,!,fy%�.�� r: ! r- _
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 ❑ Specifications for System:
Auto Dish Washer YES ❑ NO ❑
Auto Wash Machine YES ❑ NO ❑ � � /( l `/- j4
Type Water Supply
`This permit Void if sewage system described below is not installed within 5 years from date of issue. s.
!; This permit is subject to revocation if site plans or the inte ded $e change. s
q
v
,
Improvement , ermit by _
4
`Contact a representative of t e Davie County Health-De artment for fina inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. day of completion. Te ephone Number: 4-634-5985.
Final Installation Diagram: System Installed b c'
`�'�
Certificate of CompletionR 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.