130 Valley Oaks Drive Lot 4 DAVIE COUNTY ''HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued in.Compliance with G.S. of North Carolina Chapter 130—Article 130.
ri ' J Permit' Number
Name . . . � Date2057
Location, .;
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Subdivision Namerf +`�°�1r Lot No. n '_/ Sec. or Block No.
Lot Size House Mobile:Home — Business Speculation;'
No. Bedrooms No. Baths % No. in Family _
Garbage Disposal ; YES ❑ NO Ej
�I Specifications for System: , r
Auto Dish Washer YES ❑ NO ❑;; j�. �� � :��464
Auto Wash Machine i YES ❑ NO ,'D
Type Water Supply
*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 144�alth 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
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Certificate of Completion Date
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*The signing of this certificate shall indicate that1the'syste°m 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.