P5253 Turrentine Church Rd a.. X.
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DAVIE COUNTY HEALTH DEPARTMENT
1 -IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued*i-Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit- Number
NameNo
Date - _
Location
Ll F-
Subdivision Name Lot No. - Sec. or Block No.
Lot Size A House Mobile Home _ Business Speculation
No. Bedrooms No. Baths _ _ No. in Family 4 - -
Garbage
_.Garbage Disposal YES ..0 NO M Specifications for System:
Auto Dish Washer' YES [g' NO 0
Auto Wash Machine YES pl NO
Type Water Supply, _
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
a
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
i
fItr
X
F�
400
V
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
3s. DO
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 o �L' C eC) ) Date -Z N2 5253
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home _ Business Speculation
No. Bedrooms No. Baths ' `h No. in Family ri w
Garbage Disposal YES ;p NO
Specifications for System:
Auto Dish Waslier' YES 2� NO ❑ .o
Auto Wash Machine YES 02,/ NO p X X11
Type Water Supply _—
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
r +
7. d
Improvements permit by -���� r� g.`�
*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
40`
a f
Certificate of Completion Date -Z�
*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.