513 Sain 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.
Permit Number
Name - "` _ Date
Location —
Subdivision Name Lot No. Sec. or Block No.
Lot Size r'cf = House Mobile Home — Business Speculation
No. Bedrooms No. Baths — — No. in Family —
Garbage Disposal YES :E] , NO ❑ Specifications for System: `._ ' 1" ? t J a..,
Auto Dish Washer YES ❑ NO ❑ 'T
Auto Wash Machine YES ❑ NO ❑ t.l
Type Water Supply __—
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
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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 b4 C6MAT°Z1F
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314
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Certificate of Completion �� Date
*The signing of this certificate shall indicate that the system descri d above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way b taken as a guarantee that the system will function
satisfactorily for any given period of time.
4DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 130.
_
Permit Number
Name };'. _ �!',h, �1 1 L .-._ Date `" r ,,1 2F
y.
Locationr ,e� .(..� ~�� c.a�'_ i :� L c<.� _<:_ ►�
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 p Specifications for System:
Auto Dish Washer YES ❑ NO
Auto Wash Machine YES ❑ NO ❑ '• r �'
Type Water Supply 6
`This permit Void if sewage system described below is not installed within 36 months from date of issue.
r
i
moi"'^..-+.-...,"!�'� k:". '`••..,,.......,
t
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 by
3
IL�
Certificate of Completion �{ Date
*The signing of this certificate shall indicate that the system describ'�d 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.