P6534 Casa Bella Drive Lot 12.. _•-a.',.,xa S't`•,. •-:ir•;.' ..".,ti t J.,r i. v I wrc '.., 1 9r b-dy � a. a - ; -d"
DAVIE COUNTY HEALTH DEPARTMENT
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IMPROVEMENTS PERMIT AND . CERTIFICATE OF COMPLETION
*NOTEAssued in Compliance With Article II of G.S. Chapter 130a
/Sanitary Sewage Systems s� �w Permit Number
Name ��/�lt�J/X�� Date 9�� NO
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Location ���1//���✓- �F'/ �Y .�'/�?��� 4iv�/''1%
Subdivision Name ' Lot No. a Sec. 'or Block No
Lot Size House Mobile Home !� Business Speculation
No. Bedrooms No. Baths c9, No. in Family
Garbage Disposal YES ❑ NO [a-- Specifications for System:
Auto Dish Washer YES NO ❑
Auto Wash Ma shine YES T NO ❑ y
Type Water Supply a _ .
*This permit Void if sewage.system described below is not installed within 5 years from date of issue.
This permit is sub'ect to revocation if site plans or the intended use change.
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Improvements permit by __ /41
*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 RZ
'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 DEPARTMENTIMPROVEMENTS PERMIT AND.CERTIFICATE OF COMPLETION!NOTE:'Issued in Compliance With Article 11 of G.S. Chapter 130aSanitary Sewage Systems I�Xl Permit NumberNam 2k2 e2ll -V1, Date6534Location
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Subdivision Name Lot No. Sec. or Block No.
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Lot Size House -_-_-___ Mobile Home _4e�__--business _--__--_Speculation
-____--_
No. BedroomoNo. Baths =2 No. in Family
Garbage Disposal YES [] NO Specifications for System:
Auto Dish Washer YES NO []
Auto Wash K8o,:hine YESNO
Type Water Supply
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*This,permit Void if sewage system described below is not installed within 5 years from date of issue
This permit ia subject to revocation ifsite plans orthe intended use change.
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Improvements permit by !� '
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�~Contacto 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. .
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Final Installation Diagram: System Installed by Xe
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'Certificate--- of Completion^ `----
^ indicate that the system described above has been installed in compliance with
the standards set forth inthe aboveregulation, but shall inNO way betaken aoaguarantee that the system will function
satisfactorily for enygiyelperiod of time.--