P2609 Bailey RdDAVIE COUNTY HEALTH DEPARTMENT
._= IMPROVEMENTS. PERMIT I AND CERTIFICATE ! OF COMPLETION
*Note: Issued in compliance with G.S. of North lbalrolina.Chapter 130—Article 13c.
Permit Number
Name * ' gl,t .M B t r` -c,,. II II Date - /o — 8'/ 1 2
j 609
Location U n ciC, n tkss 8100 a- "'t , .k : I.I P. i 6s? - . 6-, e e ,; h'1'A, S 0
' III 45I c .x S>.n.,•.::�� t��31i �Ua� C�/
Subdivision Name"— r ' III II Lot No. fi Sec. or Block No.
Lot Size House.111mobile Home _ Business ✓ Speculation
I I
No. BedroomsNo. Baths) — lli0.�in Family fJ
Garbage Disposal : YES ❑ NO ,0� II
Specifications. for System: goo fAa11°y\ 7,x,\L
Auto Dish Washer. YES ❑ NO O" v_ Rock
S
Auto Wash Machine YE❑ NQ [Y
,
Type Water, Supply�;ua�e,
*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 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 completlor l Telephone Number: 704,;634-5985.
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- Final Installation Diagram: j) System Installed by
it
Certificate; of Completion Date
'The signing of this `certificate. shall indicate that the system describ above has been installed in compliance with
the standards set forth in the above regulation, but!
ut shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time I �I