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5555 Hwy 801SDAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c. Name' - -- Date Location Subdivision Name Permit Number 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. i i f i 1 i { t 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: O System Installed by�4'�� r� j `Alt, ' Oy_ V �— Zo— Certificate of Completion Date *The signing of this certificate shall indicate that the system describ d 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 -Com liance with G S of North Carolina Chapter 130—Article 13c v Permit Number Name Date �' �` �s 2 s Location O r t �©� j,j � ,�i 14 �� 1'111 iti ' IJ 1f Subdivision Name Lot No. Sec. or Block No. Lot Size No. Bedrooms --Z-- Garbage Disposal Auto Dish Washer Auto Wash Machine Type Water Supply House Mobile Home _ Business Speculation No. Baths YES ❑ NO p YES ❑ NO ❑ YES ❑ NO ❑ 1ilJ %% _ No. in Family Specifications for System � r i/ r•' 5 7--'D *This permit Void 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. Fina Certificate of Completion Date *The signing of this certificate shall indicate that the system descridd 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.