P2846 Hwy 601N'Note : Issued in
Name
Location.
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
?,ezLS . Date eV N 9 2846
Subdivision Narr e Lot No. -Sec. or Block No.
Lot Size House Mobile Home _ Business peculation
No. Bedrooms No. Baths No. in Family
Garbage Disposal YES ❑ NO ❑ SRe c�ifiqp tions for System:
Auto Dish Wash r YES ❑ NO ❑�ia�� yt
Auto Wash Mac ine YES ❑ NO -❑
Type Water Su ply
*This permit Void if sewage system described below is. not installed within 36 months from date of issue.
LAI
Improvements permit by
`Contact a re resentative 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 Installati n 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 standardsset 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
t
"Note: Issued iril Compliance with G.S. of North Carolina Chapter, 130—Article 13c.
Permit Number
Subdivision Name Lot No: - Sec. or Block No.
Lot Size
No. Bedrooms
Garbage Dispc
Auto Dish Was
Auto Wash Ma
Type Water Si
*This permit V
House Mobile Home _ Business Speculation
No. Baths No. in Family
;al YES ❑ NO ❑ Specifications for System:
er YES ❑ NO ❑ !i . ;
kine YES ❑ NO ❑
PpIY
id 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 Instal
on Diagram: System Installed by
/V/
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.
Name
1
f"
bate
Location,
-
Subdivision Name Lot No: - Sec. or Block No.
Lot Size
No. Bedrooms
Garbage Dispc
Auto Dish Was
Auto Wash Ma
Type Water Si
*This permit V
House Mobile Home _ Business Speculation
No. Baths No. in Family
;al YES ❑ NO ❑ Specifications for System:
er YES ❑ NO ❑ !i . ;
kine YES ❑ NO ❑
PpIY
id 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 Instal
on Diagram: System Installed by
/V/
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.
Permit Number
Name %, f ,� r Date r°`°
Location f" _
Subdivision Narj a I 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 ❑ !;, , ;,
Auto Wash Mac hine YES ❑ NO ❑
Type Water SL pply
*This permit V id if sewage system described below is not installed within 36 months from date of issue.
Improvements permit by
*Contact a re resentative 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-
/V//
y
Certificate of Completion '� " l{�� Date
*The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standar s set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactoril for any given period of time.