P3207 Hwy 801S*Note: Issued in
Name
Location
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Subdivision Na
Date
Lot No
Sec. or Block No
Lot Size House Mobile Home — Business Speculation
No. Bedrooms No. Baths No. in Family
Garbage Dispos I YES ❑ NO ❑ Specifications for System:
Auto Dish WashE r YES ❑ NO ❑ a t, r•
Auto Wash Machine YES ❑ NO -❑
Type Water Supply
*This permit Voi J if sewage system described below is not installed within 36 mg6ths from date of issue.
t
i
Improvements permit by.,'
p—
*Contact a rep r sentative of the Davie County Health Department for final inspection of this system between 8:30-
9:30 A.M. or 11
00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installatiorj Diagram:
"The signing of
the standards
satisfactorily fc
System Installed by r'
Certificate of Completion -'` Date"
his certificate shall indicate that the system described above has been installed in compliance with
t forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
any given period of time.
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
`Note: Issued'in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Name `'�, i {� iGt<.`•.! .` +L!
r
Location
Subdivision Na
Permit Number
Date
Lot No. Sec. or Block No
Lot Size House Mobile Home _ Business Speculation
No. Bedrooms No. Baths No. in Family
Garbage Dispos I YES ❑ NO ❑ Specifications for System
Auto Dish Washer YES ❑ NO ❑.\�
Auto Wash Ma& ine YES ❑ NO ❑
Type Water Su ply _— f
`This permit Void if sewage system described below is not installed within 36 months from date of issue.
Improvements permit by,,/
t
*Contact a representative 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 Installation Diagram:
System Installed by 0a t /I
Certificate of Completion Date
*The signing cf 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 or any given period of time.