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P4518 Hwy 64W_. ._:...: c'. -.. :�;:'P. ,.:,.;.> .1."�F-ry, �:... ax n _ - �' : t45. , H_:..a ,.-•,1.aF d ; �,� ,^n9,:. •5 � .,.� .`�+.'ri� .a . .�YF �.r2,'••�.51.} S3, jYL r.-f=t-'� wY',. .a .t. :- .✓:+.`,.� �to,. 010 DAVIE COUNTY HEALTH DEPARTMENT 41/`" 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: r"%/ / �7 _r %'---,. ' Date Locatio -�-, fir Subdivision Name Lot No. Sec. or Block No. Lot Size House Mobile Home _ Business Speculation No. Bedrooms -• No. Baths !7 No. in Family Garbage Disposal YES E] NO p— Specifications for System: Auto Dish Washer YES �NO ❑ J �/ ,, -� Auto Wash Machine YES NO -p�c% Type Water Supply �{ _ *This permit Void if sewage system described below is not installed within 36 months from date of issue. t a 9 9 6. I- 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 ba�e c?- in jmQ N rPu Certificate of Completion C • (� 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. I' �� - .. h -s .�_._-....-.� ..: 5..1....= ••f... w..:rv. .v ..+.n..w.,. Vis+,.;fes;.- L.V :s,'.a„ .a�;,�.+1Ys �.:ye•l�ti.o. ,.o.r ,..,.- r-, ,a. _,__. _ 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 --- J-7" Locatjo(�:e�'/, 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 F] NO ©— Specifications for System: Auto Dish Washer YES © NO J-]_ Auto Wash Machine YES NO�1� Type Water Supply__— *This permit Void if sewage system described below is not installed within 36 months from date of issue. r 1 � r l L+ 6j L 4 r 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.