120 Hobby Horse Ln (2)DAVIE COUNTY HEALTH DEPARTMENT
`c IMPROVEMENTS PERMIT AND -CERTIFICATE OF COMPLETION
*Note: Issued in,Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
,r r
Name Date TT
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size G''/%�f House Mobile Home _ Business Speculation
No. Bedrooms ----
Garbage Disposal
Auto Dish Washer
No. Baths No. in Family
YES ❑ NO
YES ❑ NO
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:
Specifications for System;
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*This permit Void if sewage system described below is not installed within 36 months from date of. issue.
i
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 i !'-l'f/'�r"'-?��
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Certificate of Completion`, l J, Date t_ t
'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.
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System Installed by i !'-l'f/'�r"'-?��
I
Wv,
Certificate of Completion`, l J, Date t_ t
'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.