126 Chattie Ln DAVIE COUNTY HEALTH DEPARTMENT ,
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLE ON �tJ
`Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 130,
�h�,c� Permit Number
Name Date NO 2070
Location $d l *- d b r air
Subdivision Name Lot No. Sec. or Block No.
Lot Size zz House Mobile Home Business Speculation
No. Bedrooms ✓ No. Baths No. in Family
Garbage Disposal YES ❑ NO ❑ Specifications for System:
Auto Dish Washer YES ❑ NO ❑ v lx fix`
Auto Wash Machine YES E] NO C] °? 1� /
Type Water Supply _— 02 7r k3 kop
*This permit Void if sewage system described below is not installed 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 betleen 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 ,' "�" ..�s�.�.._
El
• Sip �° .
Boa
Certificate of Completion Date L
"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.