1730 Peoples Creek Rd DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatment and Disposal Rules (1 NCAC 10A .1934-.1968) Permit Number
Name Po r -C z70-'(- Date��' L�� �3 91 3 4
Location S T 6)k L % %ao�j f zrr�l s_l,ts£ ��
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 ❑ Specifications for System ��Pftir�
Auto Dish Washer YES T NO ❑ ZO� X
Auto Wash Machine YES NO -E] T s �
Type Water Supply 04
*This permit Void if sewageystem described below is not installed within 36 months from date of issue. ..
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-knptnvements-permit'by
*Contact a representative of the Davie County Health Department for final inspectioff 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 LLA -
Certificate of Co leti n Date
*The signing of this certificate shall indicate that the syste des d above h een i stalled in compliance with
the standards set forth in the above regulation, but shall in N ay to en as a guaran that the system will function
satisfactorily for any given period of time.
' DAVIE COUNTY HEALTH DEPARTMENT q-'
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION r
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewa e Treatment and Dis I R le NCAC 10A .1934-.1968)'
Permit Number
Name C- z7Date/0 3403
1 >]
Location / S T L /1S-i; f-oo�j
Subdivision Name Lot No. Sec. or Block No.
Lot Size House J/Mobile Home _ Business __ Speculation
No. Bedrooms No. Baths No. in Family
Garbage Disposal YES ❑ NO D Specifications for System: 47"f „z
Auto Dish Washer YES T NO ❑ Zoo/x .3 x / $ ✓i
Auto Wash Machine YES NO -E] -S�
Type Water SupplyvN7-1- _ >--
*This permit Void if sewage /yStern described below is not installed within 36 months from date of issue.
mprGvements-pemrtf by / �%l�,•�"
*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
Certificate of Com letio ate /
*The signing of this certificate shall indicate that the system ,escri -above--h-as- een i talled in compliance with
the standards set forth in the above regulation, but shall in NO ay be taken as a guaran ee that the system will function
satisfactorily for any given period of time.