211 Baltimore Rd (2);;v�+K"y+4._�.a:�,�*tyres •vs:.%Y+.1+w°s.,;.,,t,rYpaa ar iS;E:b;�uv s:�r+ep+. ,a+. «�.`-n::,;jtA i�:.w.` _ t}' *fi $ y � .r .
*ja•ei�w'..a.w>•.�y ti+�,r ,y°9;.�.:+,k„+.,� Y•y `y,y,-... .., �,� ,.�.. r, --r :Y��-. .s,x �..:..
oa DAVIE COUNTY HEALTH DEPARTMENT
7 IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
/Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968)
Name ` ��fl���i' Lf%.�?�%—%� �� �-� Date S .l2
Permit Number
N° 5475
Subdivision Name Lot No. Sec. or Block No.
Lot Size �x(" House Mobile Home Business Speculation
No. Bedrooms ___C2,_ No. Baths No. in Family
Garbage Disposal YES p NO a Specifications for System:
Auto Dish Washer YES NO p
Auto Wash Machine YES p'' NO p "�
Type Water Supply
*This permit Void if sewage system 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 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 6
Certificate of Completion Date 3
*The signing of this certificate shall indicate that the system descri ed 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
t ' IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
r z1 "
*4OTt_- Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
,- Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
"Name L ��i Gt%-J`7 Date N2 .
Location ��;-`--��'��%��n�i ��✓ ,�7` �� -
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home Business Speculation
No Bedrooms 2 No. Baths No. in Family_
Garbage Disposal YES C NO a Specifications for System:
Auto Dish Washer YES g- NO p
Auto Wash Machine YES Er NO p
Type Water Supply air -
*This permit Void if sewage system 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 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
4,Z
Certificate of Completion Yln l -.k Date 3 " 3J
"The signing of this certificate shall indicate that the system descri 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 period of time.