P2764 Ridge 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 )AV00 11/111T Date27
.
A
Location 11 t :Gr {� c x/17) t Y'r`i r c r i< ( z' , .t ti ,- fI
Subdivision Name
Lot Size /0') , 'L u
No. Bedrooms 3
Garbage Disposal
Auto Dish Washer
Auto Wash Machine
Type Water Supply
House
_ No. Baths
YES ❑.- NO
YES p -,NO ❑
YES E]/ NO ❑
t-1) el L L_
Lot No
Sec. or Block No
MobileHome _`" Business Speculation
No. in Family
Specifications for System: q. ll��-`''
fV.'i. /+'Vrtf�rlVC Cil f<....
*This permit Void if sewage system described below is not installed 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
�\ 1JP�i L. c l_4 r M
Certificate of Completion Date � /
p
*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.