P3782 Baileys Chapel RdDAVIE COUNTY ;HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION.
*NOTE: Issued in Compliance With G.S. of North Carolina Chapter 130 Article 13c
Se,T eatment and Disposal•Rules (1'0 NCAC 10A .1934-.1968) Permit Number
Name Date 3782
'Location
Subdivision. Name' .Cot No. Sec. or Block No.
Lot Size House-� Mobile Home _ Business Speculation L--- No. Bedrooms No. Baths No.. in' Family
..
Garbage Disposal YES ❑ . NO ❑
Specifications for System:
Auto Dish Washer' YES ❑ NO .fl
Auto Wash Machine YES ❑ NO
Type Water Supply
`This permit Void if sewage system described ,below js nof'installed within 36 months from date of- issue..
J.
Improvements permit by _
f
"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 ji 1,�•�:G�f Date
I f L le -
*The signing of this certificate shall indicate #hat 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.