176 Valley Oaks Drive Lot 9 DAVIE COUNTY HEALTH DEPARTMENT -
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
`Note Issued`in Compliance with G.&-of North'CarolinaiChapter 130—Article 13c.
I' Permit Number
Name ��r i Q�t I .�/fyIlt'1 ll /%/i,.�Y` I': Date 7,P uh1j 2036
Location ' V ?F4_
VV
Subdivision Naive �fL�� YA /9 h'S Lot No. Sec. or Block No. I!
Lot -Size House Mobile Home _ Business Speculation 1/
!i
Na Bedrooms No. Baths " No: in Family
Garbage Disposal YES ❑ NO H- I; Specifications •fo�r,�System. I
Auto Dish Washer I .YES �(� 6�c/ .
N�' ❑ i
Auto Wash Machine YES 0 NO '❑
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
Improvementspermit by
Al
*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; j System Installed by
0
" 1
Certificate of Completion :c XDate /% 9
*The signing.of this certificate shall indicate that the system described 4bo4 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 anygiven period of time
. I
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 r A
i
Location —
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 i] NO E]-" Specifications for System_:_
Auto Dish Washer YES E]'. NO .0
Auto Wash Machine YES p NO O
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
J i
s
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 -
i
'1
---- ---- -------,
i
i
Certificate of Completion Date
i
*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.