P6977 Hwy 158,... .,-3,v�+a..Ra,,.-T;,,,j..,�fia.aa-a^w.t^•q:fc:"�`iyr<"w^..:.s*rw:w w.vw.ve+•��-,.tea s.�:. -...r-�—...w..:nor""-Yyr•^:,rw-°v;r^.f,�a. v,.�, 5 --
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DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION po
*NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a
Sanitary .Sewage S stems
r �J al Date �
Name �s�r��s—
Permit Number
N2 6977
Subdivision Name Lot No. Sec. or Block No.
'` ' X
Lot Size �- House Mobile Home _T Business ---.Speculation z
No. Bedrooms a ,.No. Baths No. in Family' —
Garbage Disposal YES p NO p
SpecifiQations for System:
Auto Dish Washer YES ;❑ NO''p t 1
® ,y
Auto Wash Ma^hine YES'p NO ❑ .r 3 1(�
Type Water Supply'.IS� --- .
'This permit Void if sewage systam described below is not installed within 5 years from date of issue.
This permit is subject:,to revocation if site plans or the intended use change.
.., r -t
j I
I
y,
- 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 completionz Telephone Number 704-634-5985.
Final Installation Diagram: System Installed by
.— ,Vz._,
l+V- ) ry e
Certificate of Completion Date )l
'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.
_ i e �..i � r }:.:in -'F'"+....,.« - .`,.w'"/ ;int. .r». �. ; ,,:�{ `+: ♦ F'Ts,.,, ie. jy F-ra"'-
DAVIE COUNTY HEALTH DEPARTMENT <� .
- IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
.-NOTE: Issued in Cojnpliance With Article I I of G.S. Chapter 130a
Sanitary Sewage S stems Permit Number
Name c , .t, — _>_,3.� n Date .:1 NO 6977
Location _1",-=,-
Subdivision Name / Lot No. Sec. or Block No.
Lot Size -� House Mobile Home _T Business _— Speculation
No. Bedrooms No. Baths No. in Family _
Garbage Disposal YES p NO, E] Specifications for System:
Auto Dish Washer YES ❑ NO ❑ 1 t
Auto Wash Ma thine YES ❑ NO ❑
Type Water Supply
*This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
19
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 . -Y`"
pit
lt�
Certificate of Completion p—� Date`
'The signing of this certificateshallindicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, -but shalLJn NO way be taken as a guarantee that the system will function
satisfactorily for any given period of timo
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