138 Red Fern Ln bAVIE 'COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
E: Issued in Compliance with G.S.of North Carolina chapter 130 Article 13c
Sewage Treatm nt and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
.r`i 7 Date -kms" r�F' N0 E E '
Name -
Loc on ,"') r' a i
/,
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home_-4L/'�r Business Speculation
No. Bedrooms No. Baths_ No. in Family _
Garbage Disposal YES ❑ NO E5-- Specifications for System:
Auto Dish Washer YES NO ❑ �-
Auto Wash Machine YES NO 0 ��91
Type Water Supply _ l�
*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: System Installed by
i
(shal
dCertificate of Completion _ ��.�/ Date
'The signing ofthis certificndicate that the system describeabove has been installed in comp lance 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.
"rt DAVIE COUNTY HEALTH DEPARTMENT
w" 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
Nam ef� ' j ''� �i�) _5 -24L . :1'DateTN2 2.5
LOC on r 't' �._ ✓ fJi — �%i / < ./ `' i/�. Y%1i'I r f�F'":.� ,i �c'f�� _
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home �Business Speculation
No. Bedrooms `-S No. Baths
No. in Family
Garbage Disposal YES ❑ NO E5-' Specifications for System:
Auto Dish Washer YES NO
Auto Wash Machine YES NO ❑ c��� `S�l�
...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.
r
Final Installation Diagram: System Installed by
Certificate of Completion ,'' Date
"Tlie'signing of this certificat 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
K IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
a 'NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatment and Disposal Rules (10 NCAC 10A A934-.1968) Permit Number
�'Date �_ Y ,�` N2
_ — 52 �
�
Location S-'/,/��
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home —y�Business Speculation
No. Bedrooms No. Baths g2 No. in Family _
Garbage Disposal YES ❑ NO 2'' Specifications for System:
Auto Dish Washer YES NO 0
Auto Wash Machine YES NO .❑ �V/1
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
�PGc1
4
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 byC Z2�2� zlz�
F
Certificate of Completion Date
'The signing of this certificat 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.