P3019 Rainbow Rd~u DAVIE . COUNTY HEALTH -DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued ii Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name Date T i
Location
Subdivision Na a Lot No. Sec. or Block.No.
Lot Size House Mobile Home _ Business Speculation -
No. Bedrooms No. Baths R No. in Family
Garbage Dispo al YES E] - NO ❑'- Specifications for System:
Auto Dish Washer YES ❑ NO ❑'
Auto Wash Mac iine YES E], ---.NO ❑
Type Water Su ply
*This permit Void if sewage system described below is not•installed within 36 months from date of issue.
Improvements permit by
*Contact a rep r sentative 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 Installatio. Diagram: System Installed by
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ire- 14 T
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Certificate of Completion Date '
*The signing of t1his certificate shall indicate'that the system described above has been installed'in compliance with
the standards sot 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.
a DAVIE .COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*Note: Issued i i Compliance with G.S. of North Carolina Chapter 130—Article 13c.
Permit Number
Name t 11- L n , k_... Date
Location fl r \. 1 t ii:. c,, t;t,,.. h'. t i)?_A _
Subdivision Ne
Lot Size
No. Bedrooms
Garbage Dispc
Auto Dish Was
Auto Wash Ma
Type Water S
*This permit V
Lot No.
Sec. or Block No.
House `"� Mobile Home — Business Speculation
> No. Baths 1 No. in Family
;al YES p NO [f Specifications for System:
er. YES NO E}'
nine YES p�NO 2���X }(r•��
PPIY vJ r I t d �,, s, E] „ P
id if sewage system described below is not installed within 36 months from date of issue.
Improvements permit by . � i1-\C~Al
d
*Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-
9:30 A.M. or :00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram: System Installed by
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/ v' %
imix 1,11,171 /i7
Certificate of Completion Date
*The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standardset forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily f r any given period of time.