2091 Junction 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
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
'Z701k /
Name elhl � Dates vy - ,�' f: 355
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size House 4/ Mobile Home_ Business Speculation
No. Bedrooms 3 No. BathsNo. in Family �--_
Garbage Disposal YES ❑ NO ❑ Specifications for System:
Auto Dish Washer YES NO ❑ r r(
Auto Wash Machine YES NO ❑
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
Improvements permit by
i'
*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
1
Certificate of CompletionDate
"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 be taken as a guarantee that the system will function
satisfactorily for any given period of time.
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 NCAC 10A .1934-.1968) Permit Number
NameA1A1tW, &-fJ:5o1'J Ba't 333r�c.1�,y Date- �`� '� ` 35554
Location '`�Ait�ifJR&'L- Sr . (,uacttr,�r� A ��J,nSi �Y7t:,___ fL�V41lS/�3 ��l�r'+[.
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: j'g?Aire
Auto Dish Washer YES d] NO ❑
Auto Wash Machine YES 4j,, NO -❑
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
• r
1
Improvements permit by J ,�-
Y
*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 66S_S—s1 -f�NK—
Certificate of Completion Date r
*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.