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907 Yadkin Valley Rd DAVIE COUNTYTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE:Issued in Compliance With Article 11 of G.S.Chapter 130a Sanitary Sewage Syste\s Permit Number Name A`N Date N2 580 5 Location `�� \ , I Lo ':76 Subdivision Name Lot No. Sec. or Block No. Lot Size Do LHouse Mobile Home _ Business Speculation No. Bedrooms No: Baths No.-in Family�— Garbage Disposal ,s YES ❑ N0 [9' Specifications for System: Auto Dish Washer YES [—gfl NO°[DAuto Wash Machine YES C�. NO ❑ 4 0 �/ 7 �` , S 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. . .<Y / Oar O 14 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�/�'L, /Bo jtI'G w n r ©! d Certificate of Completion Date 7A2� "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. DAVIE COUNTY"iiEAL'TH DEPARTMENT < -IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *'NOTE:Issuedin Compliance With Article I I ofG.S.Chapter 130a Sanitary Sewage Syste\rT , Permit Number, Name ���r a �j \�� c� �l \Z. Date �l N� J 5 Location c , �\ Subdivision Name Lot No. Sec. or Block No. Lot Size House V Mobile Home _ Business _— Speculation No. Bedrooms 3 No. Baths No. in Family _ Garbage Disposal YES ❑ NO (pl Specifications for System: - Auto Dish Washer YES Fd NO ❑ Auto Wash Machine YES NO ❑ tr; �� , `, .� it 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. ° 13 _. I- - 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. r_ Final Installation Diagram: System Installed by(,-,/ /00 0 O� � r Certificate of Completion �� Date lI71Q "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. " • INFORMATION FOR SEPTIC, SYSTEM REPAIR PERMIT NAME A cJ 2 PHONE NUMBER ADDRESS Ry csA Io� SUBDIVISION NAME SUBDIVISION LOT f DIRECTIONS TO SITE y r . DATE SEPTIC SYSTEM INSTALLED �I ►,,,Q NAME SEPTIC SYSTEM ORIGINALLY INSTALLED UNDER SPECIFY PROBLEMS THAT ARE OCCURRING DATE REQUESTED 1 "`� ' �� INFORMATION TAKEN BY \��