1631 Yadkin Valley Rd (2) ' DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND .CERTIFICATE OF COMPLETION
*NOTE;Issued in Compliance With Arlicle 11 of G.S=Chapter130a�
SanitarySewa e S stems _ 6k. Permit Number
^Z�a /.g /V._� /?
Name J)
NO
' 537
Location 'f" ' I it �12
ky
ray✓ �1� _ _
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 Ma.hine YES [� NO ❑ 'i --:, X/,'V
Type Water Supply
*This permit Void if sewage system described below is not installed within 5 years from date of issue.
This'permit is subject to revocation if site plans or the intende se change.
g
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 Installation Diagram: System Installed by
!
.3
Certificate
1
l
1
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 CERTIFICATE OF COMPLETION
_ E:' .
*NOTE:Issued'in Compliance With A icle I of G.S.Chapter 130a
C , Sanitary_Sewage Systems �/✓IL�-IS, —OGtJ/'✓ �- Permit Number
...Nam m ;rLOe / r�i l i �1' /G,'� Date –/��`-' T N2
6537
..Location ��'.,
Subdivision Narie�~ Lot No. Sec. or Block No.
Lot Size House Mobile Homer Business _— Speculation
No. Bedrooms '—.No. Baths _ No. in Family
—
Garbage Disposal YES ❑ NO 2 Specifications for System:
Auto Dish Washer YES NO ❑
Auto Wash Ma,hine YES NO ❑ 't��� ,� '
Type Water Supply __—
*This,permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intende se change.
,ql (�
) A! //A�
Improvements permit by —_ Z y
*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 !�� �
1
1
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.