P2420 Jerry WoodDAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
`Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c.
r7� Permit Number
Name Date !- i/ N O_
2421
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 C1 NO C1. Sp ifications for System:
Auto Dish Washer. YES E]NO ❑/%�,�
Auto Wash Machine YES ❑ NO C❑
Type Water Supply
*This permit Void if sewage,system d sc ibed below is not installed within 36 months from date of issue.
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i.00�t s
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: 704-63/4-5985.
Final Installation g n allation Diagram: System Installed by L ' ' M�Tt
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cfn
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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 1 i ��r C�-, r„ - r Date f
1%
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
_ No. Baths ' No. in Family.
YES ❑ NO ❑
YES ❑ NO ❑
YES ❑ NO ❑
— Business Speculation
Specifications for System:
� . f._ .�- ter"' ��, __•�, �/...� i �/
`This permit Void if sewage system described below is not installed within 36 months from date of issue.
1, 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 Instal lation,Diagram." System Installed by
Certificate of CompletionDate
9
*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�_ l f"�'%' +i �� i r; Cis Date % �` ' "J�' �� !� 2 tF 20
Location
1�§2 - 1's -
Subdivision Name Lot No. Sec. or BlogkNo.
Lot Size House Mobile Home _ Business Speculation
No. Bedrooms No. Ba,6 No. in "Family
Garbage Disposal
YES
;❑
NO ❑
Auto Dish Washer
'YES
❑
NO C❑
Auto Wash Machine
YES
❑
NO [
Type Water Supply
Specifications for System: r
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
i
I rovements 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.
V 3y L , fl, MAK--r
Final InstallatLoni'
l, gram:j, System Installed b
Certificate of Completion j ` 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.