579 Pudding Ridge Rd (2) ..z,- 'w �`--'y''-W +ra4:+'tiH ^�.. ..�-._ w +ra'N"'+'tiiWr��rr',,. "va4••a'.�:ti-�""'� - •+'
Wi'�=" i?:t}'r, w:F. '� "C'rti9 r `i""�t '�+r^ "�'.r-+- -k* •tr + ix'�'evr --r °_ '.sw-sem'- i`+�.
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE:Issued in Compliance With Article II of G.S.Chapter 130a
/ )tary image sysye�ns_ / / Permit Number
Name e�r1e •✓dr✓�5 rs � ����'•"I/ Date — CSl/lj�' tic 73, 0
Location �- 'r� o%l%jt yD,v .�n/- !� 7��
ev.✓
Subdivision Name Lot No. Sec. or Block No.
Lot Size �gC House Mobile Home —J- Business Speculation
No. Bedrooms a No. Baths No. in Family —
Garbage Disposal `YES ❑ NO
� Specifications for System:
Auto Dish Washer; YES ❑ NO
Auto Wash Ma.hive YES ❑ NO a J�
Type Water Supply ---
This permit Void if sewage system described below is not installed within 5 years from date of issue.
l This permit is subject to revocation if site plans or the intended use change.
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 bynt�-orr
Q W
Certificate of Completion Date !/-,),Q - 1�
'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 betaken as a guarantee that the system will function
satisfactorily for any given period of time.
h DAVIE COUNTY HEALTH DEPARTMENT
•"� `= ;IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTC Issued in Compliance With Article I I of G.S.Chapter 130a
f a itaryS wage Systems ,� ;, Perm 1 �I,u1f1 or
Nam `is J �` Date � --
Location
r
Subdivision Name Lot No. Sec. or Block No.
' Lot Size House Mobile Home _✓r__ Business __ Speculation
No. Bedrooms No. Baths No. in Family �c _
Garbage Disposal YES ❑ N9 Specifications for System: '
Auto Dish Washer YES ❑ NO
Auto Wash Ma:hive YES ❑ NO,p 1�
Type Water Supply
*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.
F
Improvementspermit 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
E
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.