123 Redwood Drive Z-LotDAVIE,,COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c --T
Permit Number
26TS
Name Date
Location
111� Ao
Subdivision Name-- Lot No. Sec. or Block No. V
Lot Size House ~ Mobile Home Business Speculation
No. Bedrooms No..Baths No. in Family
Garbage Disposal YES -C] "NO Specifications for System:
Auto Dish Washer YES NO
Auto Wash. Machine, YES .NO C]
Type Walter Supply
*This permit Void if sewage systerri described below is not installed within 36 months from date of issue.
Improvements permit by
*Contact, a representative of the Davie. County :Health Department for final insp ction o this system between 8:30-
9:30 A.M. or 1:00-1:30 e.M. 'on day of completion. Telephone Number: 704-6 4-5985.
Final Instailatio Diagram System Installed by
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lat 4 �o VDagr
Diagram
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--certiTiate of G, ompletioln Date
�s
*The signing of this certificate shall that the system des ib
�b d 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 pe , riod of time.