P5854 Greenwood Lakes Lot 4q,46 DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance With Article II of G.S. Chapter 130a
Sanitary Sewage Systems
Permit Number
Name , Z (`(V, r, ti,r
Date n 10
�
N2 5 r 5 42
Location ���" \ Wit.—' l�
�i V �' c 1 ��J •'
1 f-:, t - \� \ cam `ZS O \ S
�-._ (s -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 ED,-'
Specifications for System:
Auto Dish Washer YES L NO ❑
N 1,
%A/
Auto Wash Machine YES pi' NO ❑
Type Water Supply
---
*This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
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: -
o
61
System' Installed by
U 9,
t` 'r aV
Certificate of Completion DateLA
'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 betaken 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't'�
*N_ OTE: Issued in Compliance With Article 11 of G.S. Chapter 130a
Sanitary Sewage Systems Permit Number
Name Date ! N2 Ly.
�=
Location
Subdivision Name "L_ Lot No. Sec. or Block No.
Lot Size House �/ Mobile Home — Business Speculation
No. Bedrooms No. Baths — No. in Family r - 7—
Garbage Disposal YES ❑ NO [�� Specifications for System:
Auto Dish Washer YES d NO ❑ l 1�
Auto Wash Machine YES 0/ NO ❑
Type Water Supply •.r ---
*This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
71! +vol
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.
i
Final Installation Diagram: System Installed by Q�N���`'N�
C)
\N A 0�J�� rYA,I
Certificate of Completion Date
*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.
INFORMATION FOR SEPTIC SYSTEM REPAIR PERMIT bfii O p0 1
NAME p �J � PHONE NUMBER
ADDRESS �' '� ��-� SUBDIVISION NAME
SUBDIVISION LOT N
DIRECTIONS TO SITE l `6
DATE SEPTIC SYSTEM INSTALLED
NAME SEPTIC SYSTEM ORIGINALLY INSTALLED UNDER
SPECIFY PROBLEMS THAT ARE OCCURRING
DATE REQUESTED INFORMATION TAKEN BY
Dam? County Neallh Department
and Moine Nealth ffyency
210 HOSPITAL STREET I P.O. Box 665
MOCKsvILLE. N.C. 27028
PHONE: (704) 634.5985
April 27, 1990
Don Lamonds
Rt. 3, Box 326
Advance, NC 27006
Re: Sewage System Repair
Permit 95854
Greenwood Lakes/Sec. 7 -Lot 4
Dear Mr. Lamonds:
The sewage sysi:em at the aforementioned address was repaired and working
at time of inspection on April 10, 1990.
Enclosed .is a copy of the Improvements Permit and Certificate of
Completion.
Sincerely,
C5�
Charles E. Little, R.S.
Environmental Health Section
CL/wd
Enclosure