649 No Creek Rd 6
DAVIE COUNTY HEALTH DEPARTMENT I
IMPROVEMENTS PERMIT AND CERTIFICATE OF. COMPLETION
`Note:Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name ;r', Date
Location J> f
Subdivision Name Lot No. Sec. or Block No.
Lot Size ` House Mobile Home _ Business Speculation
No. Bedrooms No. Baths �J No. in Family
Garbage Disposal\ YES ❑ NO ❑•- ~' Specifications for System:
Auto Dish Washer YES ❑ NO ❑ {!`�; 4 y ' �� f _ ...
Auto Wash Machine;, YES ❑ ---NO ❑
Type Water Supply`;G: / :j
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
t
f�
;11
i
Improvements permit by
*Contact a representative of the Davie C my Health Department for final inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day o completion. Telephone Number: 704-634-5985.
Final Installation Diagram: System Installed by6?_1P1k""1
Certificate of Completion Date
*The signing of this certificate shall indicate that the system describ d 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
`NotesIssued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name <" - Date �' '.-. r;
Location ,= i�
Subdivision Name Lot No. Sec. or Block No.
Lot Size fes` r House Mobile Home _ Business Speculation
No. Bedrooms No. Baths �� No. in Family '
Garbage Disposal, YES ❑ NO ❑--r' Specifications for System:
Auto Dish Washer YES [:] NO ❑ ,> y�� ;t/� '- , : -' f ,' i` r f
Auto Wash Machine; YES ❑ --NO -❑
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
/ j
17
r
r
1
i
-f Improvements permit by
'`Contact a representative of the DavieCo my Health Department for final inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day ofcompletion. Telephone Number: 704-634-5985.
4
Final Installation Diagram: System Installed by
o
-
Certificate of Completion �U 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.