118 Summer Sweet Dr Lot 7 • '` DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P.O.Boa 848/210 Hos Hospital Street
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Mocksville,NC 27028 </ 144P'r
(336)751-8760 /ZS
Account #: 990003994 Tax PIN/EH#: 5880-51-5022.07
Billed To: Craig Carter Builders, Inc. Subdivision Info: Magnolia Acres Lot#7
Reference Name: Marty Location/Address: Summer Sweet Drive-27028
ATC Number: 4427
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental
Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to
the Davie County Building Inspections Office when applying for building permit(s)(in compliance with Article 11 of
G.S.Chapter 130A,Wastewater Systems,Section.1 00 Sewage Treatment and Disposal Systems). THIS
AUTHORIZATION FOR WASTEWATER COINSTRUCTION IS VALID FOR A PERIOD OF FIVIE YEARS.
Environmental Health Specialist's Signature: Date:As stated in t" � Luu,7k"
01PAP 4Q-
---accepted"iv;
ems may a o-be use
CER E 0 ,COMPLION
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**NOTE** The issuance of this Certificate of al ' 'cateiFsystem described on Improvement/Operation Permit
has been installed in compliance with Article 1 G. . apter 130X,Section.1900"Sewage Treatment and
Disposal Systems,"but shall in NOW en a g tee tha ithe system will function satisfactorily for any
given period of time.
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Septic System Installed By: 4� mj �
Environmental Health Specialist's Signature: ate: 7
DCHD 05/99(Revised)