P3096 Hwy 601NDAYIE COUNTY HEALTH DEPARTMENT .
c IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued ir Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name' r - Date
Location
Subdivision
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:
Auto Dish Wash , -r YES ❑ NO [EE]'
Auto Wash Machine YES ❑ NO ❑ '✓
Type Water Su ply
*This permit Vold if sewage system described below is not installed within 36 months from date of issue.
\
IN,
i
Improvements permit by
*Contact a repr sentative 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 Instal
i Diagram: System Installed by
le ion �% - <a
Certificate of Comp Date t
"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 fo any given period of time.
Y.
a DAVIE COUNTY HEALTH DEPARTMENT
r •' �;~ IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
L)-hj:��
it
/ -PermNumber
Name' n ' '�.' Date �, a% T" / s;j'
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home _ Business 1�' Speculation
No. Bedrooms No. Baths No. in Family
Garbage Disposal YES ❑ NO p-`'
Specifications for System:
Auto Dish Washer YES E]NO ❑ .-
Auto Wash Machine YES ❑ NO F,�
4
Type Water Su ply
"This permit Voild if sewage system described below is not installed within 36 months from date of issue.
Improvements permit by.
*Contact a rep esentative of the Davie County Health Department for final inspection of this system between 8:30-
9:30 A.M. or :00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installatio Diagram: System Installed by ►' / ����
TV
l �
Certificate of Completion Date zz
"The signing ol this certificate shall indicate that the system described above has been installed in compliance with
the standards pet forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily f r any given period of time.