Loading...
P3597 Edgar Trivette='.;, ., _.y � .,. �y • ., a.-"..i..J< .;...r '. .sem... ... _ .�.i a..i .tsa-i i»w r • .r, Y.. ..1:.. +.... --.1""'l r�"�— .. .si4 i...:. ... .._ _ .... .. .x > Ali 4': 30 DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance with-GlS..of North Carolina Chapter 130 Article 13c Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number Name Date j '�� `9� 3597 Location Subdivision Name Lot No. Sec. or Block No. Lot Size House Mobile Home — Business Speculation No. Bedrooms No. Baths r ` No. in Family Garbage Disposal YES ❑ NO fl Specifications for System: Auto Dish Washer YES p NO ❑ Auto Wash Machine YES W NO ❑ Type Water Supply *This permit Void if sewage system described .below is not installed within 36 months from date of issue. f 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: 3� 0 14 M 9 �v v System Installed by "Zb , l 1 Yvtt-'tom `" g,3a—SSS Certificate of Completion Date *The signing of this certificate shall indicate that the system describe 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 wit,h,GtS.,,of North Carolina Chapter 130 Article 13c Sewage Treatment and Disposal Rules (10 NICAC 10A 1934-1968) Permit Number Name Date N® 3597 Location 2 Subdivision Name. Lot Lot Size House Mobile Home ' No. Bedrooms NO.in'Family . No. Baths - Sec.,pr Block No. I : - - Business. Speculation Garbage Disposal YES [] NO 0 Specifications for System: -Auto Dish Washer YES © NO E]-. . " ., '. h 4'- . Auto Wash Machine YES, -er, NO '4 F -I Type Water Supply *This permit Void if sewage system described below is not installed within 36 months from date of issue. Improvements permit. by_.li, 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: AV 10 System Installed by y. L ti &Aa Certificate of Completion Date IT "The signing of this certificate shall indicate that the system describe 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 Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-:1968) Permit Number PJal7re Date �J.3597 Location Subdivision Name Lot No. Sec. or Block No. Lot Size, House Mobile Home Business Speculation No. Bedrooms _ No. Baths No. in Family _ Garbage Disposal YES ❑ NO E Specifications for System: Auto Dish Washer YES ❑ NO ❑ Auto Wash Machine YES Q NO ❑ Type Water Supply *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: Svctam Inctallari by delSao M" v 'h l �I Certificate of Completion t�``''" ' Date g r *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. STATEMENT DAVIE COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH SECTION 210 HOSPITAL STREET P. 0. BOX 665 MOCKSVILLE, NORTH CAROLINA 27028 (704) 634-5985 DATE y L I DETACH AND MAIL WITH YOUR CHECK. YOUR CANCELLED CHECK IS YOUR RECEIPT. Cb �: j