P2950 Wagner 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 NO.
. 2950
Location �ool,
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile' Home — BusinessSpeculation
No. Bedrooms_ No. Baths Z No. in Family
Garbage Disposal YES ❑ NO ❑ Specifications for System:
Auto Dish Washer. YES ❑ NO ❑ �i
Auto Wash Machine YES ❑ NO ❑
Type Water Supply ---
*This permit Void if sewage -system described below is not installed yWithin 36 months from date of issue.
A/0
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
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.