148 Valley Oaks Drive Lot 6 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
Name 'M ✓�� Date
s. < 2268
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Location —
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Subdivision NameLot No. Sec. or Block No.
Lot Size House Mobile Home — Business -- Speculation
No. Bedrooms No. Baths 'No. in Family
Garbage Disposal ! . YES ;[] No, l" ''
Specifications for System:
Auto Dish Washer YES NO p ,/
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.
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Improvements permit by
*Contact a representative'of the Davie;County Health Department for final inspection of this system between 8:30-
9:80,
:30-9:80,A.M. "or 1:0071:30 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram System Installed by �F
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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 in the above regulation, but shall in NO way be taken as a guarantee that the system will function
i satisfactorily for any given, period of time.. 1
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
Name _ ,,' Date
P
Location —
Subdivision Name Lot No. !' Sec. or Block No.
Lot Size House ' ' Mobile Home — Business -- Speculation
No. Bedrooms No. Baths %'`'f No. in Family —
Garbage Disposal YES ❑ NO ❑rte Specifications for System:
Auto Dish Washer YES g NO ❑
Auto Wash Machine YES ,'Ij NO �]
Type Water Supply
}
*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 "" 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
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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.
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DAVIE COMI'T'Y HEALTH DEPART MUT ,
PERCOLATION TEST RESULTS
DATE
NAPSE
LOCA^►ION- /� S '0014L
FINDINGS: HOLE 110. COtMMEIITS
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By:
' LOT DIAGIIWI
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