2527 Hwy 64W DAVIE" COUNTY HEALTH ,DEPARTMENT ,
IMPROVEMENTS 'PERMIT AND CERTIFICATE OF COMPLETION .
`•Note: Issued in Compliance with G.S. of North Carolina Chapter 130==-Article 13c.
Permit Number
Name vA`4-jiS ri a e,.�. Date io- n n- Sea ,i 255
Location'
Subdivision Name Lot No. Sec. or Block No.-
Lot
o:Lot Size f House 1, ""' Mobile Home— Business Speculation
No. Bedrooms No. Baths' 1 • No. in Family
Garbage Disposal YES .E] NO 191 Specifications 'for System:
Auto Dish Washer YES i, NO 'Q' �3 'XXx
-
Auto Wash Machine YES i,• NO F_I
Type Water Supply We I
*This"permit Void if sewage system described below is not installed within 36 months from date of issue.
v
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 R.M. on day'of completion. Telephone Number: 704-634-5985.
Final Installation Diagram; System Installed by zy,
pq'l
Sb� X3 y 1-4 1 0`
Certificate of Completion Date
-*-The signing of4his certificate shall indicate,that the system described above has .been installed in compliance with .
the:siandards-set forth.in the above regulation, but shall in NO way be taken as a guarantee that the system will function
ti� satisfactorily-for any given period of time.
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.S. of North Carolina Chapter 130=Article 13c.
Permit Number
Name �T 1, Date
Location , : ��;< <;i_ a•. << t, - � ti _
,
Subdivision Name No. _ Sec. or Block No.
Lot Size O ; . • House Mobile Home Business Speculation
No. Bedrooms " No. Baths ? No. in Family _
Garbage Disposal YES .� NO 0- Specifications for System:
Auto Dish Washer YES p- NO E] ,(7/C,
Auto Wash Machine YES p- NO p
Type Water Supply __—
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
r
i-
�r
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 �,,1��.-
N
I
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.