141 Valley Oaks Drive Lot 20 DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT.AND;; CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
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Name V / , F ! j' �C /9'i ,� !� Date f �041
it :r P07
Location —
Subdivision Name lI1 "�' ! � Lot No. Sec. or Block No.
Lot Size House Mobile Home _ Business Speculation Y
No. Bedrooms No. Baths No. lnf Family
Garbage Disposal YES LJ NO ®:/
Specifications for System:
Auto Dish Washer 1 YES 2-"NO F]
Auto Wash Machine YES NO,-,[]
Type Water ,Supply H fl--- C_ s�S' roVt r�
.`This permit Void if sewage system described below is not installed within 36 months from date of issue.
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Improvements permit by-T)
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*Contact_a representative 'of the Davie County Health Department for final inspection of this system between 8:30
9.30 A.M. or l.:00-1:30 P.M. on day of completion. Telephone Number: 704- 634-5985.
Final Installation Diagram z �� (Q{I'I j System Installed by
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Certificate,of Completion V o Date S
'The signing of this certificate shall indicate that the system described above has been installed in compliance with
he.-tandards set forth'in the above regulation, but'shall in NO way be taken as a guarantee that the system will function
ctorily for any given'period of time.