806 Joe Rd (2) DAVIE COUNTY HEALTH DEPARTMENT
_ IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
'NOTE:Issued in Compliance With Article I I of G.S.Chapter 130a
Sanitary Sewagesyst ms QQ// /Jfo<�s'r/'i���/ Permit Number
Name _52Z4111P Datel��J
Location _ <�
fs� - ----
Subdivision Name Lot No. Sec. or Block No.
Lot Size � � _ House Mobile Home —_ Business -- Industry
No. Bedrooms _.No. Baths __J_ No, in Family�_— Public Assembly Other
Garbage Disposal YES ❑ NO ❑ Specifications for System:
Auto Dish Washer YES ❑ NO ❑ , d�
� v r
Auto Wash Ma^hine YES ❑ NO �-
Type Water Supply
'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
ATTENTION: YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMITOYOUT BEFORE INSTALLING THIS
SYSTEM.
�Wt 11
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.,
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
-70
C_,5 -"t ------
G /
Certificate of Completion -- Date _
'The signing of this certificate shall indicate that the system described above has been installed in compliancewith
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
`NO;'E:Flssued in Compliance With Article 11 of G.S.Chapter 130a
Sanitary Sewa�g-e/Systems /J�a�r(r� ��� Permit Number
�c1 / -- i
t*lame' )� i�% ' t, .�' Date
Location e)`— .f f✓ " ( ��-1<L��/1z /.� = _ �f,►e c�
"Subdivision Name Lot No. Sec. or Block No.
Lot Size "�� �--- House Mobile Home ---- Business _— Industry
No. Bedrooms 42 _.No. Baths --/-- No. in Family�_— Public Assembly Other
Garbage Disposal YES ❑ NO ❑ Specifications for System:
Auto Dish Washer YES ❑ NO ❑ /? � 1;
Auto Wash Ma^hine YES ❑ NO ❑ /G !/Crr t.�
Type Water Supply ----- -- e .-✓��%�j /
*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
ATTENTION: YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTALLING THIS
SYSTEM.
I .f�In
•
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.,
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
1 2�
V
,t
Certificate of Completion r1 -- 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.