P2601 Hwy 601SDAVIE 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 ` c e . iNNOIL � Cvwlnl Date f t Q� – ' YI ' , i 2601
Location ��o4a �ay.a1... W',11:a,.r ITev-AZr)
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 • p-
_ Specifications for System:
Auto Dish Washer- YES ❑ NO [g-
Auto Wash Machine YES ❑ NO ;E-.
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
Improvements permit by � • �•.. �
. V
*Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-
9:30 XM. or 1:00-1:30 P.M. on day of completion. Telephone. Number: 704-634-5985.
.Final Installation Diagram: System Installed by �a.Uti.-- S`$ �•
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.
i F
t
7n41 634.6985
1' ��ff
January 13, 1981
-
i
Mx. Fred Mock
!£F"...:'
Palmi AT�a�xc#� �e�t1#I�
�e�ttx#mPxt#
e East Bend,, N.C. 27108
r
Re; Rent Building -601 South
Davie County
P. O. BOX 57
ucksia'slte, -nxt4 (Carolina
27028
Mork. .
cot
QFfICE OM THI 0 RECTOR
TELEPHONE
7n41 634.6985
January 13, 1981
i
Mx. Fred Mock
6 Route 2
e East Bend,, N.C. 27108
r
Re; Rent Building -601 South
Davie County
Mork. .
.' 2t has been brought to the attention of this office that the