P3509 Junction RdDAVIE 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 S"�F� 3509
Location l nllI T e,A r t —_-y,A ,,c 1\ r . T7.0 - c T--"_ C"_t"t
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 ❑ NO ❑ Specifications for System: Zook 3'X1a
Auto Dish Washer . YES ❑ NO ❑
Auto Wash Machine YES ❑ NO -❑
Type Water Supply (' : s 4b L
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
Improvements permit by—L
*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:
talled by
Certificate of Completion Date _�9-0/_
*The signing of this certificate shall indicate that the system descri ed 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.
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
NameDate S "�-qKid 30-09
Location (',,,,ICC,,,, e 7:7v-A,.c .\" rr,p M s r- �'.NI \"11�-
Subdivision Name
Lot Size
Lot No
Sec. or Block No.
House Mobile Home _ Business Speculation
No. Bedrooms 2— No. Baths No. in Family
Garbage Disposal YES ❑ NO ❑ Specifications for System: Z oo'K
Auto Dish Washer YES ❑ NO ❑ 6
Auto Wash Machine YES ❑ NO �❑ /tjV
Type Water Supply ( )c_ -- ' - Ucb L ,.11
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
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:
tailed by ��--
Certificate of Completion Liv"' DateIV
*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.