225 Wing Haven Ln (2) �. .. ... .....s.F.. .n�....a.:s —.r, ,,y ) .4y ".v,^d ,.. � Y 3 ... a;t.:.,A9 t is r,d•:, ., . , . .- .
DAVIE COUNTY HEALTH DEPARTMENT
! 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 N_CAC 10A .1934-.1968) Permit Number
= Name t ,% c r ;` �� „< -_---- - Date
Location
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 ❑ '-
j.f���
Auto Wash Machine YES NO ❑
Type Water,Supply
*This permit Void if sewage system described-be ow is not insfalle-d 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 by
Certificate of Completion �'J 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.