414 Farmington 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
rSewage Treatment and Disposal Rules 0 NCAC 10A .1934-.1968) Permit Number
)ZT. L uT 13
Name C>h�= WA-U- trot�w«<< Date - I 3 ' 3428
Location F—AZfr"NG iR-1- 15 PA-eA
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home --4'' Business Speculation
No. Bedrooms ? No. Baths No. in Family _
Garbage Disposal YES ❑ NO ❑ Specifications for System:
Auto Dish Dish Washer YES ❑ NO ❑
Auto Wash Machine YES ❑ NO •❑ —
Type Water Supply ;> c'
!l
*This permit Void if sewage system described below is not instal ledam
witKin 36 months from date of issue.
7H
t
1
1 •
1
i
Improvements permit b' 5�-��=
*Contact a representativeothe`gav e County Health Department for final inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M aay of completion. Telephone Number: 704-634-5985.
Final Installation Diagram: System Installed by
Ce ' 'tate of Completion Date 714 . .
*The signing of this certificate shall indicate that th tem described above has been installed in compliance with
the standards set forth in the above regulation, but shall in as a guarantee that the system will function
satisfactorily for any given period of time.
s DAVIE COUNTY HEALTH DEPARTMENT
- f 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 0,-NCAC 10A .1934-.1968) Permit Number
Name J � t C_ iL tic ieG 1 <3 Date
LocationAjZ{ry,in►G i�, IZ-i� tr--_ F�c' 13� u,�- F rflt�i`1 f C�,Q-{!•.�r C,RO��n�
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 ❑
Auto Wash Machine YES ❑ NO ❑ —+ '—
Type Water Supply
"This permit Void if sewage system described below is not installeiwi{fiianX36 months from date of issue.
W q
Pe_v
Improvements permit b
*Contact a representative of e vie County Health Department for final inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. n ay of completion. Telephone Number: 704-634-5985.
Final Installation Diagram: System Installed by
'til
.w
3f
y
l -
\"C3er ificate of Completion pate '
*The signing of this certificate shall indicate thatth-e--system described above has been installed in compliance with
the standards set forth in the above regulation, but shall in RG-Way-be-taken-as a guarantee that the system will function
satisfactorily for any given period of time.