1052 Greenhill Rd (2) .d 0 ✓Xo
DAVIE COUNTY HEALTH DEPARTMENT
5 IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE:Issued in Compliance With Article II of G.S.Chapter 130a
Sanitary Sewage Systems Permit Number
NameNO 6942
Locationi9w ��
Subdivision Name Lot No. Sec. or Block No.
Lot Size J�l�C House Mobile Home Business Speculation
No. Bedrooms No. Baths No. in Family _
Garbage Disposal 'YES ❑ NO ❑ Snecifi8ations for System:
Auto Dish Washer YES ❑ NO p 0 t p
Auto Wash Ma^hine YES p N0 ❑ yy �l�� �� SCJ i4 0�/
Type Water Supply ---
*This permit Void if sewage system described below is not installed ithin 5 years from date of issue., �
This permit is subject to revocation if site plans or the inten ed us change.
ty ped
`,rr 6 ��
�Lu —` I Yv e S
e7
r
Improvements permit bY
*Contact a representative of t e Davie Cc my 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 ompletion. Telephone Number 704-634-5985.
Final Installation Diagram: 1 yDSystem Installed by p
3 40`
x-10 Us e
4
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:
DAVIE COUNTY HEALTH DEPARTMENT oa,�
IMPROVEMENTS PERMIT AND
j� ,.
CERTIFICATE OF COMPLETION
'NOTE:Issued in Compliance With Article I I of G.S.Chapter 130a
�nitary$ewage Systems. �,
Pe�rmltsf�r��er
Name ,( Date N_
Location
' S—i9�% f�•'/� l/ i/f' Tor (G'/�t'fi./i-�� rl /�- //yi�i` �fl y "" sy
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 ❑ S rLf�ations for System:
Auto Dish Washer YES ❑ NO ❑ "�
Auto Wash Ma^hine YES ❑ NO ❑ '' '/ G�
Type Water Supply __—
•This permit Void if sewage system described below is not in talledfwithin 5 years from date of issue.
This permit is subject to revocation if site plans or the inten ed use change.+r,
,)�
Improvements permit by --
'Contact a representative of t e Davie Co my Health 71pephone
artment for final inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. n day of ompletion. Number 704-634-5985.
-y------
Final Installation Diagram: System Installed by —
.,____
F-H 3 U,1
c'
t"
L
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.