752 Will Boone Road Lot 3DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
'Note- Issued in Compliance with G:S. of North Carolina Chapter 130—Article 13c.
Permit Number
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Name �+ - u �.ti� •t r.;5
77
rvYr�Date '7 '�'- t�.. fr.
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Location
Subdivision Name o Lot No. 3 Sec. or Block No.
Lot Size House Mobile ,Home Business Speculation
. jl I
No. Bedrooms - No. Baths,, • No. in Family
Garbage Disposal ; YES .:E] NO Specifications for System: rlrbI
Auto Dish Washer YES ®' NO ❑
41
Auto Wash Machine YES.' E NO: ❑
. 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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4i. Improvements permit by.
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*Contact a representativ6� of ,the Davie County Health Departmentfor 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.
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Final Installation Diagram; lj System Installed;by
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I
Certificate'of,Completion eft;.e� ce;�;c Date 7 ` 4
"The signing of this certificate shall indicate that'th'e'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.. i
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DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS 'PERMIT AND .CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G,S.-of North Carol ina°Chapter 130 Article 13c
Sewage Treatment* and Disposal Rules (10,•NCAC- 10A .1934-:1968) . 'Permit Number
Name�_5 Datei 1- Z S - gs�� 4127:
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Location t
Subdivision Name r'`?:y►{A' - Lot No. -3 Sec. or Block No.
Lot Size. House Mobile Home _ Business Speculation
No. Bedrooms No. Baths No. in -Family _
Garbage Disposal YES ❑ N0 ❑ Specifications for, System:
Auto Dish Washer YES E] NO E]e.('
Auto Wash Machine YES ❑ NO ❑
Type Water Supply _ ' �' (^A IZ11-I
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
r• /2��l,hc Ola
- Improvements permit byy`C���..:��.�
wntact 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
. 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:
DAVIE COUNTY HEALTH DEPARTMENT
PERCOLATION TEST RESULTS
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DATE /D "2/- P4
NAME e �� 11 e I b, -V
LOCATION W;11 AOw--6p�fa
FINDINGS: HOLE NO.
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3.
COMENTS
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DAVIE COUNTY, HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
- it I ,
`Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit -Number
Name `�< ut�,� CIS" 1�,��. Date '..r 3-i''`. [
1
nratinn , t 1i1-blo., e_
I it
Subdivision -'Name TO Lot No. _ Sec. or Block No.
Lot Size House Mobile Home _ Business Speculation
No. Bedrooms - 'l No. Bath's - No. in ;Family
Garbage Disposal I 11YES p NO :E p' I' Specifications for System: ejr�
Auto Dish Washer � YES p' NO fl 11 .11
Auto Wash Machine �I AYES H`. NO ii ` '�
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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,
• Il 1 1: li'
Improvements permit by
1
*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:Il " ! System Installed by nr.,�" 11"7"
1 . if!it1 ,
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It
It it
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it I
j Certificate of, Completion Date
*The signing -of this certificate shall indicate that'the isystem described above has been installed in compliance with
the standards set forth in the above regulation, but'sh'all in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time. i.
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