P2311 Hwy 601NDAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name �, / > i; / ff Date
Location
Subdivision Name
4
Lot Size +' House
No. Bedrooms =" No. Baths.
Garbage Disposal
Auto Dish Washer
Auto Wash Machine
Type Water Supply
YES p
. NO
YES p
NO p
YEl!S p
E
NO []
Lot No
Mobile Home
No. in Family - >
Sec. or Block No.
Business Speculation
Specifications for System:
*This permit Void if sewage system described below_is not installed within 36 months from date of issue.
r
Improvements permit by
J
*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.
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
r� Permit Number
Name. -s -�C��'1�� Date
Location��` /,r`—" r' /� ,� r✓' f f1'. '�% ���l�
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 p NO p-! Specifications for System:
Auto Dish Washer YES p NO p
Auto Wash Machine YESp NO p
Type Water Supply
*This permit Void if sewage system described below. is not installed within 36 months from date_ of issue.
f
i
Improvements permit by
l
*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
o letion eW�' f- l" -'6'S' Date / r_9Certificate •f C mp�i
*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.