445 Baileys Chapel Rd ._... ..,. �IYldP,^Y''ra'ti"c+5',�+�"};�.�'`v��%'`T`a+gra-+.'"� maahttYce`ws✓�i++rawr�an+vYr—. wP.�y^�^w++^--}-svic_..-;-w-:-�^.Y..'a�-�-'aw.'-t.•-.-a..o.� �-T.,
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DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
. *NOTE:Issued,in Compliance With Article 11 of G.S.Chapter 130a
Sanitary Sewage Systems �(?.��ro7sB,
f Permit Number
Name r /na�,r��p SCG Date e69 LV9-0!-V- p N2 6988
Loca
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home _ Business _1/ Speculation
No. Bedrooms .No. Baths No. in Family s
Garbage Disposal YES ❑ NO ❑ Specifications for System:
Auto Dish Washer YES ❑ NO
Auto Wash Ma;hive YES ❑ NO ❑ ? j�
Type Water Supply
*This permit Void if sewage system described below is not installed within 5 years from date of issue.
his permit is subject to revocation if site plans or the intended use change.
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Improvements permit by __Al
*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
lJor
. r
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.
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DAVIE COUNTY HEALTH DEPARTMENT
Y-{ IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
NOTE:Issued in Compliance With Article II of G.S.Chapter 130a
Sanitary Sewage Systems ���c�r,2 '' �� Permit Number
;.: f O
Name 1__rl 1 1p?,: Date ��-%�1 N2 �1 Q O
Location JSr 6F'✓ iii//,!;!d!C ` !y �� /r�f�,�%��;' — �� %,/ ,' ! c, F � /i f i
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home _� Business Speculation
No. Bedrooms fl .No. Baths No.,in Family
Garbage Disposal YES ❑ NO ❑
Auto Dish Washer YES C] NO ❑ Specifications for System:
Auto Wash_Ma shine;-,, YES,, NjOc❑ �.
Type Water Supply ;- --- A 42
*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.
h
' 1
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
r
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 N0 way be taken�as a guarantee that the system will function
satisfactorily for any given period of time.