P2879 Hwy 64WDAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS, PERMIT AND CERTIFICATE. OF COMPLETION
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Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit. Number
,'/t%/,�•fiJ's"": e 2�9
NameDat
Location
Subdivision Name, Lot No. Sec. or Block No.
Lot. Size House �� Mobile Home _ Business __ Speculation
f
No. Bedrooms No. Baths No. in Family
Garbage Disposal YES. NO " O' Specifications, for S ,stem:
Auto Dish Washer YES 4 NO 0>✓'��,. /�
Auto Wash Machine YES NO
Type Water 'Supply
"This permit Void if sewage system described below'i"snot installed within 36 months from date, of issue.
17
!
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 bye
i.
Certificate of Completion ! Date 223
'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.