1577 Davie Academy Rd (2) DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c .
Sewaagg Treatt ent d Deposal Rules (10 NCAC 10A .1934-.19 8) Permit Number
Name L � `/ o�9//L�'� Date . N2 3623
Location �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 ;p NO pr' Specifications"for System:
Auto Dish Washer_ YESNO
Auto Wash Machine YES NO F
Type Water Supply
*This permit Void if sewage system described below.is not installed within 36 months from date'of issue.
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
*The signing of this certificate shall indicate that the system describe 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
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
`NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewae Treat e/nt_71d Disposal Rules (10 NCAC 10A .1934-.1/968) , Permit Number
Name �i`�t '- --lex /rt lr Date i/ 1� �'`� 9' 3623
Location
�' ? ,'�:-ll�'�;l/j/I�'k_,�r�.z�'r �`.J /,�G'%" `f,�-�,��,J4�'� �'Y.� - �?li/ri-/f,^ � ••, - .1
Subdivision Name Lot No. Sec. or Block No.
Lot Size House `'�— Mobile Home Business Speculation
No. 'Bedrooms No. Baths Z No. in Family
Garbage Disposal YES ❑ NO Ej-- Specifications for System:
Auto Dish Washer YES NO ❑
Auto Wash Machine YES NO -❑
Type Water Supply E/��' _—
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
Improvements permit by — -7`
*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
II
1
Certificate of Completion C,- ���^^�" 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
Sew,ae Treatment and Disposal Rules (1O NCAC 10A .1934-.1968) Permit Number
Name Date - 3623
j
1
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size` House Mobile Home _ Business Speculation
No. Bedrooms 6 No. Baths No. in Family
Garbage Disposal YES NO p' Specifications for System:
Auto Dish Washer YES NO .Q _
Auto Wash Machine YES NO p
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
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
!I
Certificate of Completion ` cJ2-- Date 7
*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.