P7459 La Quinta Drive+yxi:r amt cw+��cis>.Nt c r. 'tq.,.
¢� Kn..� .c*rT 'kti' +x^'"t� ,sr.�� �'->i'+r`•r�^1fFti';ya�`s Vr.srtit;w�
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
'NOTE: Issued in Compliance With Article II of G.S. Chapter 130a
Sanitary Sewage Systems Permit Number
Name _C r �i� �r n�l��D to�S 10-9f� N2 7 4 5 7
Location .��rL/� �lt .{//' rl'i✓ �F'G Q�/OSS 7 /O.�n �s�J�'
Subdivision Named d� ��� �-�J ? Lot No. Sec. or Block No.
Lot Size House Mobile Homey Business -- Industry
No. Bedrooms_. No. Baths No. in Family =, Public Assembly Other
Garbage Disposal YES ❑ NO ❑ Specifications for System:
Auto Dish Washer YES ❑ NO ❑
Auto Wash Ma shine YES ❑ NO ❑
Type Water Supply _ r!D
*This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
Aaa
Improvements .permit by .�ZZ
'Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M.,
1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram:
System Installed by _
t.
Certificate of Completion " .Date /
ti..
'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 guaranteethat the system will functior
satisfactorily for any -given period of time,,
r.. .. 4
DAVIE COUNTY HEALTH DEPARTMENT
- IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*.NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a
Sanitary Sewage Systems �r Permit Number
..Name r�r (0�'-'alw 1i�x��r_i� X01, nate s� /�-�� N° 7 4 5 9
Location �. A r�/�/;; yl //r- rTi✓ G /�/ S� /o✓� /�,�J� _
�
)
Subdivision Name yZ" Lot No. ,t Sec. or Block No.
Lot Size House Mobile Home Business __ Industry
No. Bedrooms No. Baths No. in Family _ Public Assembly Other
Garbage Disposal YES ❑ NO E]Specifications for,System:
Auto Dish Washer YES [-]NO ❑
Auto Wash Ma^hine YES ❑ NO EJ/ <}�� /I/pi j
Type Water Supply 4-4
'This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change:
AAd
�r
m f�
Improve ents permit by
'Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M.,'
1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram: System Installed by —
« s
Certificate of Completion Date i l
*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 anylgiven period of time._