P4299 OakdaleDAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treat , ent and Disposal Rules (10 NC C' 10A" .1934-.1968) Permit Number
Name y� y, f ;% ►/ /.��/ Date `�������5� J? f Gi
Location
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Subdivision Name
Lot No. Sec. or Block No.
Lot Size
House
Mobile Home — Business Speculation
No. Bedrooms 77
No. Baths —~'
�• 7
No. in Family _
Garbage Disposal
YES ❑ NO
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Specifications for System:
Auto Dish Washer
YES NO
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Auto Wash Machine
YES NO
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Type Water Supply
__—
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
Improvements permit b
*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 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.