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4314 Hwy 64EDAVIE 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 -9 2, SALy% c3�,n�� rn rT rase Date I )6 i5 N? 2257 Location (o v,4,it n, Qf-cias ' Vla S�� t� S-ia� �-- a 04 Subdivision Name Lot No. Sec. or Block No. Lot Size House Mobile Home _ Business Speculation No. Bedrooms Garbage Disposal Auto Dish Washer Auto Wash Machine Type Water Supply _ No. Baths No. in Family. YES ❑ NO YES ❑ NO C❑ YES ❑ NO ❑ Specifications for System: /.5-6 5'3 "A- 2, (e /rte *This permit Void if sewage system described below is not installed within 36 months from date of issue. zW F1. x/27 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 Instal led.by �Jdliv►,�� Certificate of Completion Date *The signing of this certificate shall indicate thatthe 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 r 1 I , : 1 t' ;� Date Location ;iC i } i )F l \ i < t 9✓r^7_� Ir. ( �r 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. C Ji 1 `_ Wit. �`:_^�' �.1r �// �.� J u^f(i.i•'�� y C/ . r 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: i� r. 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. Permit Number Name Date Location Subdivision Name Lot Size No. Bedrooms Garbage Disposal Auto Dish Washer Auto Wash Machine Type Water Supply Lot No Sec. or Block No. House Mobile Home — Business Speculation _ No. Baths No. in Family _ YES ❑ NO ❑ Specifications for System: YES ❑ NO '❑ r..r/" YES ❑ NO �❑ ;' %^ ,y� ..'✓ '`This permit Void if sewage system described below is not installed within 36 months from date of issue. 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: j f. 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. �1 f. 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.