P2093 Hwy 601SDAVIE COUNTY HEALTH DEPARTMENT /�
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETIO /x:`36
*Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name �-� N ;� r"�,' r , �� — Date 'J
i°eel y�
Location
Subdivision Name Lot No. Sec. or Block No.
__, 'Lot Size _ House _� ' J Mobile Home _ Business Speculation
i
No. Bedrooms No. Baths No. in Family
Garbage, Disposal YES ❑ NO ❑ Specifications for System:
Auto -Dish Washer YES ❑ NO
Auto Wash Machine YES ❑ NO 0
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
E'
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 3�(��'k140
Certificate of Completion Date 46127
*The signing of this certificate shall indicate that the system described above has7rantee
n installed i co p ance with
the standards set forth in the above regulation, but shall in NO way be taken as a gu 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.
f
Permit Number
-Namedr'ra' . • - Date
Location ✓`l:";: tel.', 4/ :fig -' f�/ l�Y''';�f" f,� C� ) o ,�^,1../�
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 ❑
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.
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
Certificate of Completion r�/ �'f-� 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.