278 Random Road Lot 7 Section 2DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMITAND CERTIFICATE OF COMPLETION — —
*Note: Issued in Compliance with G.S. of No h potp,C apter 130—Article 13c.
_ Permit Number
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Name—r%•;%!/ L���i E/✓ Date
Location />L%%l/,•�i i��jf '�"y�S =� _
Subdivision Name
Lot No. 7 Sec. or Block No. 2–
Lot Size
House
Mobile Home _ Business Speculation
)�
"1
No. Bedrooms
No. Baths
No. in Family _
Garbage Disposal
YES ❑ NO
❑
Specifications for System:,
Auto Dish Washer
YES p NO
❑
; •/ j
Auto Wash Machine
YES p NO
Type Water Supply_—
*This permit Void if sewage system described below isnot installed
7 ` e:1
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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 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:
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1
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, b'ut 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
`Note: Issued in Compliance with G.S. of
M
Name S i';eyiC/ rrJ c i✓'
Location
roa Chapter 130—Article 130.
"m `, I _ ' Permit Number
C f r'
Date SJ �` J rte""
—N
Subdivision Name Lot No. Sec. or Block No.
Lot Size House �% " Mobile Home — Business Speculation
No. Bedrooms No. Baths x` 'No. in Family =ter
Garbage Disposal
Auto Dish Washer
Auto Wash Machine
Type Water Supply
YES ❑p NO ❑
YES p NO I]
YES p NO ❑
s'1
Specifications for System:
*This permit Void if sewage system described below is not installed
e_Lr
J
in 36 months from date o
Grl�'X
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: 704-6345985.
Final Installation Diagram:
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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 RtAL'TH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR Jz �hpl OY/ w%. DATE a-/1-2�(—PERMIT
N9 99
LOCATION
// S.R. NO.
SUBDIVISION NAMEDu�fruJd Tf4 CS LOT NO. SECTION OR BLOCK NO.
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES L°7 NO ❑
AUTO. DISHWASHER YES— N0 ❑
AUTO. WASH. MACHINE YES ,L_em,.,' NO ❑
SITE SUITABLE YES Cg/NO ❑
SIZE OF TANK IOoA gal`.
NITRIFICATION FIELD O . sq. ft.
DEPTH OF 'STONE IN LINES;
WATER SUPPLY: Individual ❑ Public
IMPROVEMENTS PERMIT BY "' T7 — yL6.GM
CERTIFICATE OF COMPLETION
By
(8/16/73) *Construction must com
LOT AREA
House Trailer 800 Gal. 400 Sq.,Ft.
Two Bedroom House 800 Gal. 600 Sq. Ft.
Three Bedroom House 900 Gal. 900 Sq. Ft.
Four Bedroom House Cf Gal.. 1200 Sq. Ft.
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�JJ t�/4�C' a6�e ex7/r•Prhe/y ��jii.
STrrcnt G awe r ' S.dP Or
i
INSTALLED
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Date -3-1S —
with all other applicable State and local regulations
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