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P4017 Hwy 158.,,..-.-a... '`.. .... .. ....:. ... ....-... ...r ..i:.JT'•;.. ...-... � •: r- :...awl-a.v't`. f w Y . .. - .. _ - .! _ �.. .._.. .r . DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c - Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number + Name Date' Location t :7 u - t=e, . ; C h .c, _ G""- 4'' "" 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 ❑ Specifications for System: Chc 0u 7 "^ t- '. P Auto Dish Washer YES ❑ NO ❑ nu 1 . 1, C\ �'H"R-- �"-T Y\tw-7..,.�f.. Auto Wash Machine YES ❑ NO ❑ Type Water Supply �•.c t __— `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 oLD aNY- Certificate of Completion Date 20- "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. DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number Namee-171- Date - z� -sus" tyD 491 Location r _ - s' Subdivision Names Lot No. Sec. or Block No. Lot Size House Mobile Home _ Business Speculation No. Bedrooms Z No. Baths No., in Family Garbage Disposal YES ❑ NO ❑ Specifications for System: cl,< Auto Dish Washer YES ❑ NO ❑ :---- Auto Wash Machine - YES ❑ NO -❑ •Yooc; r,._C � r.,ri.,� �1'D � - 1 � o� = X 5 F Type Water Supply "This permit.Void if sewage system described below is not installed within 36 months from date of issue. Improvements permit by N- I rV'_. *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 �` rr� �,- ,o..,.,.« AAK- ^•U �t 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.