121 Speer Rd (3) D"IE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c'
Sewage Treatmeat and Disposal Rules (10 NCAC 10A .1934-.19,%) Permit Number
Name Date N 63 '
Location
Subdivision Name Lot No. Sec. or Block No.
Lot SizeZY
House A�Mobile Home - Business -- Speculation
No. Bedrooms _ No. Baths No. in Family _:22__
Garbage Disposal YES .0 NO [-r' Specifications f ys m:
Auto Dish Washer. YES NO .04wrW-7 I k_�
Auto Wash Machine YES NO p
/�xr
L
Type Water:Supply
"This permit Void if sewage system described bel w is not installed within 36 months from date of issue.
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
(\�the
Certificate of CompletionDate �2ith
The si nin of this certificate shall indicate that thes stem described above has been installed in com lianc with standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
�tisfactorily for any given period of time.