P2613 Milling Rd.CIO
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
"Note:.lssued in Compliance with G.S. of North Carolina Chapter 130—Article 130,
Permit Number
Name ; ,l,, ;.t ;,;, (l Date - i ! a ':
Location i , , s c_. + ,.i r: ;�..J,
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 p
Specifications for System: �r
Auto Dish Washer
YES ❑ NO ❑
-; ; . zi4.- /Sb X 3 X Z`� 5�*J�
Auto Wash Machine
YES ❑ NO ❑
%
Type Water Supply
'This permit Void if sewage system described below is o stalled within 36 months from date of issue.
All
.t
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'AUt .1 ��'��� J�•
Certificate of Completion Date I✓ll
*The signing of this certificate shall indicate that the system descri d 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.
Permit Number
Name�'tJtJ4� { 1';`Ii•,l'> `^ Date 2
LocationY ;; t �. t ems, t 1 tai. I\C q c>
Subdivision Name Name
Lot No. Sec. or Block No.
Lot Size
o House �''
Mobile Home _ Business
Speculation
No. Bedrooms -'
No. Baths -
No. in,Family
Garbage Disposal
Auto Dish Washer
YES :❑ NO p
Specifications for System:
�
YES ❑ NO El)',,-
1,r lSt� X3
Auto Wash Machine
YES ❑ NO -❑
Type Water Supply
i
f
f
*This permit Void if sewage system described below is no ailed within 36 months from date of issue.
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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 l 4 U/ t" I (-k AR"P -J/Q-,
Certificate of Completion0 L�� 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.
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f
i
0 r i- /I, i L-
1- 1 t -j s
1""', 0'1 't t? I I 1 1 '4-1 ( L J) 6,
C.. t.
t
�.. { f t'• i � �� � fir: C> Y^ "};� i.:.'A,=� � �
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 l 4 U/ t" I (-k AR"P -J/Q-,
Certificate of Completion0 L�� 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.