159 Myers Rd \.. ,..,:r' F,:-p.y ..t iy`.Y...,. K+-b+Y+.'d'JV' r ;,.:.`rr, bj"vpt' $`r^M,'3.i'a� .. p. a - , - t . • .. a:rl"" h,'r'-..
DAVIE COUNTY HEALTH DEPARTMENT �l••a�
t IMPROVEMENTS PERMIT AND .CERTIFICATE OF COMPLETION
*NOTE:Issued-i Compliance With Article 11-of G.S.Chapter 130a 50 rob
Sanitary Sewage Systems Permit--Number
Name Date 5-IL- 9! N2 6 3R' 5
Location
Subdivision Name Lot No. Sec. or Blo
Lot Size AL Houses Mobile Home —v Business, Speculation
No. Bedrooms No. Baths leo. in
Garbage Disposal YES p NO–W Specifications for System-, IkIx
Auto Dish Washer` YES pw NO �, �-�, D
Y
Auto Wash Ma thine YES :NO ❑ w
J ,
Type Water Supply
*This permit Void if sewage'sysiem described belowisnot installed within 5 years from date of issue.
This'permit is subject to revocation,if site plans or the intended use change.
if
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
Y 'R 1p
Certificate of Completion Date W
"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.
\ .,•r,., .,, ....-. :rte-•"i'• ;.:. `;:' q
} o`
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND .CERTIFICATE OF COMPLETION ` - 0,00
NOTE:Issued in Compliance With Article 11-of G.S.Chapter 130a -
;',
",!Sanitary Sewage Systems Permit-Number
IVam_ e� ak S ccs• Date ' `�� N° 63
Location JZ _
Subdivision Name Lot No. Sec. or RIo-ok-N ,.
Lot Size y House n Mobile Home —1� Business Speculation $'
r
No. Bedrooms No. Baths — fro. in Family
Garbage'Disposal *YES p� NOR[p/ Specifications for System:,, D
Auto Dish Washer YES E] NO g/ % - -�.,, 1� - .
Auto Wash Ma tphine YES [ NO t
Type Water Supply
*This permit Void if sewage system described belowisnot installed within 5 years from date of issue.
This-permit is subject to revocation if site plans or the intended use change.
b
-.1
J
4.q,. _
Improvements permit°by _. c, ,a._ �'
— f --- — —
*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 t
a
f
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.