324 Rhynehardt Rd L
DAVIE COUNTY HEALTH DEPARTMENT � r�r
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 (10 NCAC 10A .1934-.1968) Permit Number
Name n 4, rr. �. s .� i 'l`�E� ra r Date N� ��1��33 9
Location
Subdivision Name Lot No. - Sec. or Block No.
Lot Size House V Mobile Home — Business Speculation
No. Bedrooms No. Baths — V _'No. in Family
Garbage Disposal YES E) NO Specifications for System:
Auto Dish Washer ` YES ❑ NO +�.
Auto Wash Machine YES pl NO fl 11°
Type Water Supply
*This permit Void if sewage systemdescribed below is not installed within 36 months from date of issue.
a
+I
/f 'provem nt ermit b
*Contact a representative of the Davie County Health Department pr final inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day of completion, Telephone Numb er'.7,.4;6345985.
Final Installation Diagram: System Installed by �-
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S
__ f J U T
Certificate of Completion _���u �3%Dat eoC
*The signing of this 'ficate shall indicate that the system described above has been installed in compliance with
the standards set forth in t e • n but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
°'C7W.`.".:: /,.: ;ti.s"' 'y f.i."!;'r"^' ad! -' r�LY{i.a $-•`°'/'i. a s .,. ....a : .... r .. Y.c\. i. _ . .. Y•;' . ..i•
�.' DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND, CERTIFICATE OF COMPLETION
*NOTE:',k Issued in Compliance with G.S. of North Carolina,Chapter 130 Article 13c f
,Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
Names 4a r<, Date �� - t - NO
Location �'.�C :, �'g 0, (n i'A 6
V, 1A '
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:
Auto Dish Washer YES ❑ NO 2-'
Auto Wash Machine' YES R NO ❑ ; ti
Type Water Supply \> _ x X
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
TAa.. I1 cl
�f
rovemen permit by
*Contact a representative of the Davie County Health Department inalni spection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M: on day of completion. Telephone Nu fae . 4-6544985.
Final Installation Diagram: System Installed by-
I +�
� av3 �
e
J
Certificate of Completion Date
'The signing of this extificate shall indicate that the system described above has been installed in compliance with
the standards set forth in tie above-rega but shall in-NO way be taken as a guarantee that the system will function -
satisfactorily for any given period of time.