550 Junction Rd (2) DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
`Note: Issued in Compliance with G.S. of North Carolina Chapter 130-Article 13c.
_ Permit Number
Name Date
Location
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Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home _ Business Speculation
No. Bedrooms No. Baths No. in Family
Garbage Dispos I YES ❑ NO ❑ J'� ' n Specifications for System: lf?vllo Cv,
Auto Dish Wash r YES ❑ NO ❑ "� . — _. •`- _ i >�X 'x�L"/<'uc_
Auto Wash Mac ine YES ❑ NO ❑
Type Water Su ply ( ' __ t�`,.: �1�, ;,.; . 2 , a �,;s ! C" ;
_s
J
`This permit Vo d if sewage system described below is not installed within 36 months from date of issue.
r_.
5
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Improvements permit by
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"Contact a re resentative 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 corrf�letion. Telephone Number: 704-634-5985.
Final Installat on Diagram: System Installed by /�
Certificate of Completion c�yi t`ti'�(t^ Date
*The signin of this certificate shall indicate that the system described above has been installed in compliance with
the standar s set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactoril for any given period of time.