P2644 Riverdale 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
Name Date
/,yam r
Location 405
Subdivision Name
Lot No
Lot Size / �' House Mobile Home.
No. Bedrooms, - No. Baths No. in Family _
Garbage Disposal YES ❑ NO ❑
Auto Dish Washer YES ❑ NO
Auto Wash Machine YES ❑ NO ❑
Type Water Supply
Sec. or Block No.
Business
Specifications for System:
Speculation
*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 Dgram: �.
VV
19
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System Installed by
Rad t"� 4 r':;.
> 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.
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 .r%% ; ::,, .� "' - - Date -;f ,%" �-' ,
2 .
Location ; - ✓/
/ ,`���7l %! /�f �✓//-/:'}'7-(" ('%�,;=
Subdivision Name Lot No. Sec. or Block No.
Lot Size / r J.< House Mobile Home — Business Speculation
No. Bedrooms• -'� No. Baths f No. in Family
G
NO
arbage Disposal
YES ❑
❑
Specifications for System:
Auto Dish Washer
YES ❑
NO Q
Auto Wash Machine
YES ❑
NO ❑
i ;l
Type Water Supply
"° �, r -i.,
__
�>°
" /' - '✓" s�<<-i%�-
`..
*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:
1
System Installed by r��
1�'u c ,T.
Certificate of Completion � `r`1�1i''�' Date 14/
V
*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.