P2415 Martin Luther King Junior RdDAVIE 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 !�< Q_ Date
t -
C .
Location
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 ❑
Specifations for Systemir i<.� '!r /'c''
Auto Dish Washer
YES ❑
NO ❑
Auto Wash Machine
YES ❑
NO ❑
- `' _' t. E
_
Type Water Supply
1
"This permit Void if sewage system described below is not installed within 36 months fromdate of issue.
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47
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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:
.qvctam InOnifori by
----------------------- i
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'
II
`Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
_ Permit Number
Name Tz Date I 2-� t"
Location�'i1�. , i.�> C L.
Subdivision Name Lot No. Sec. or Block No.
Lot Size _
No. Bedrooms
Garbage Disposal
Auto Dish Washer
Auto Wash Machine
Type Water Supply
House —
_ No. Baths
YES ❑ NO ❑
YES ❑ NO ❑
YES ❑ NO ❑
6,9u r! -r -%
*This permit Void if sewage system described
Mobile Home _ Business Speculation
No. in Family _
SScifjcations for System;,
r
elow is not installed withi' 36 months from date of issue.
6t_ip LIrJ:_ '
r �
i
Improvements permit by
'15
*Contact a representative of the Davie County Health Department for final inspection of this
9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram:
Avetam InOnIlarl by
I u_lx T?
between 8:30-
` o &vb _
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.