P5074 Bobbitt Rd../~ ., DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
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*NOTE: Issued inCompliance With G.S.nf North Carolina Chapter 130 Article 13o '
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
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Location
Subdivision Name Lot No.' Soo. or Block No.
Lot Giza House Mobile Home Business __-____- Speculation
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No. Bedrooms _-�_l-__ No. Baths -_=2 No. in Family
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Garbage Disposal YES [] NO [}^~ Specifications, for System:
Auto Dish Washer YESNC]�]
Auto VVaohk4achine YES U7 NO �]
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Tvoa Water Supply
*This permit Void if sewage system described below is not installed
within 38 months from date of issue.
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Improvements permit bv
*Contact a representative of the Davie County Health Department for final inspection of this uyebsm between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number: 7O4'S34'6S85.
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Final |nabd|aUnnDiagram: 8vob*m|no�l�dby `
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Certificate
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erdficaUyofCompletion OoU* '
The -- d that the system described above.has been installed i compliance '
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
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satisfactorily for any given period uftime.
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DAVIE COUNTY HEALTH DEPARTMENT
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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) Permit Number
r `Name moi' �_ -T Date vP/�/_r _---
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size House —� % Mobile Home _ Business Speculation
No. Bedrooms— No. Baths —- No. in Family —
Garbage Disposal YES ❑ NO
Specifications for System:
Auto Dish Washer YES ❑ NO ❑ , ,,
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Auto Wash Machine YES] 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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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
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.