P2412 Hwy 158DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
`Note: Issued in Compliance'•with G.S. of North Carolina Chapter 130—Article 13c.
'No
Number
Name T ��ll�� Date Iv 2412
Location
Subdivision Name ` / Lot No. _ Sec. or Block No.
Lot Size House Mobile Home Business Speculation
No. Bedrooms._ No. Baths G-- , No. in Family_
Garbage Disposal YES C NO I[ Spe ificati n
Auto. Dish Washer ` YES NO ���
Auto Wash Machine YES NO.
Type Water Supply _
'This permit Void if sewage system described below, is not.installed within 36 months from date of issue.
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
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Name Date
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size House ' A Mobile Home _ Business Speculation
No. Bedrooms No. Baths No. in Family l
Garbage Disposal
Auto Dish Washer
Auto Wash Machine
Type Water Supply
YES ,0 NO Specifications -for System:.; ,
YES E]NO p ; f�:,:�__•: "� -= ,= � :? . �.
r-
Ej u 14O u
"'This permit Void if sewage system described below is not installed within 36 months from date of issue.
1-7
s�
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
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.
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.
,/ / Permit Number
Name .����,;°'.a'� u/"�'ii,Date/.�='�� 21 1
Location
Subdivision Name
Lot No.
Sec. or Block No
Lot Size House �'/ Mobile Home _ Business Speculation
No. Bedrooms 7F' No. Baths No. in Family
Garbage Disposal YES E] NO �
Specifications for SysteT•
Auto Dish Washer YES p NO
Auto Wash Machine YES p NO p
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
- l
Improvements permit byI�f=-` r
*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 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.