P2459 Edward Beck RdDAVIE COUNTY .HEALTH DEPARTMENT �=
IMPROVEMENTS PERMIT AND -CERTIFICATE OF COMPLETION
*Note: -Issued in Compliance with G.S. of North Carolina Chapter 130—Article 130,
Permit Number
Name - ` < Date ,.
Location -
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home Business Speculation
No. Bedrooms 'r' _~ No. Baths No. in Family
Garbage Disposal YES ❑ NO ❑
Specifications for System:
Auto Dish Washer YES ❑ , NO ❑
Auto Wash Machine YES ❑ NO ❑
-L Type Water Supply �:., v� � : �. , �,_ _ , :� r= :� • ;
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
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
dy
61
Certificate of Completion Date
*The signing of this certificate shall indicate that the system described ab as been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken a guarantee that the system will function
satisfactorily for any given period of time.
DAVIE COUNTY HEALTH DEPARTMENTIMPROVEMENTS PERMIT PERMIT AND CERTIFICATE OF COMPLETION
`Note:-Issued_.in Compliance with G.S. of North Carolina yChapter 130—Article 13c.
Permit Number
Name t L i f� "� E�� C lQ' Date f
Location C\-rZ l.. ,` C I; 1? i? 0
�; rr C �(� r:r r: Cr t f.C.
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 ❑ NO p'�
Specifications for System:
��� 1
Auto Dish Washer
YES ❑ NO1
❑
t j 2 y �= f�
1 1 • i !1 �J
J'
Auto Wash Machine
YES E] NO 0
Type Water Supply L -nu t, r -i f' / __I 6,04'ea ro, Si ;
`This permit Void if sewage system described below is not installed within 36 months from date of issue.
j1r
t
Improvements permit by
*Contact a representative of the Davie County Health Department for final inspection of this system between 00-
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 Completions 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.