P2247 Oak Grove Church RdDAVIE 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
7r
Name �,t 1fir r c.. (G; _: Date
Location�! '' (2'
Subdivision Name Lot No. Sec. or Block No.
Lot Size House �''� Mobile Home
No. Bedrooms, No. Baths f No. in Family.
Garbage Disposal
YES
❑
NO ❑
Auto Dish Washer
YES
❑
NO ❑
Auto Wash Machine
YES
❑
NO ❑
Type Water Supply
Business Speculation
Specifications for System:
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
Improvements permit by
"Contact a representati4',of the Dav`ie.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 Z)4L'
Certificate of Completion 1 Date
"The signing of this certificate shall indicate that the system describeY 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 ��V. *� fr*. r't' i r <'/•� Date
Location
r.,
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home
r
No. Bedrooms `�� No. Baths / No. in Family.
Garbage Disposal
Auto Dish Washer
Auto Wash Machine
Type Water Supply
YES ❑ NO ❑
YES ❑ NO ❑
YES ❑ NO ❑
Business Speculation
Specifications for System:
"This permit Void if sewage system described below is not installed within 36 months from date of issue.
Final Installation Diagram: System Installed by,1, "7
i---\
Certificate of Completion , -� ` (tf�t'o I Date /o -A4
*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.