235 Madison Rd /YO
DA1iiE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE:Issued in Compliance With Article II of G.S.Chapter 130a
/Sanitary Sewage Systems Permit Number
Name Date DateNO
6.6
Location �) ' J
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 p' Specifications for System:
Auto Dish Washer YES Q NO ❑
Auto Wash Ma shine YES ] NO ❑
Type Water Supply /lP
*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.
d
r
Improvements permit by — all
*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 c
Lo'
Cert i i cateof Completion IDate
'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.
VIye
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS (PERMIT AWCERTIFICATE CERTIFICATE OF COMPLETION
*NOTE:Issued in Compliance With Article II of G.S.Chapter 130a
`Sanitary Sewage Systems, Permit Number
Name AznZz Date . N2
Locationrrf iL 0
Subdivision Name Lot No. Sec. or Block No.
Lot Size House 1Z Mobile Home Business Speculation
No. Bedrooms -- .No. Baths _ No. in Family
Garbage Disposal YES ❑ NO p' Specifications for System:
Auto Dish Washer YES NO ❑
Auto Wash Ma:hive YES j NO ❑ ` (��XXf
�\ 15'- �
1 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.
i
y
I
t ,
t
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
A
_ I
I
Certificate of Completion l ! l I Dater f`
*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.