P2939 Bill HudspethDAVIE 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 / _ Date
Location —
Subdivision Name Lot No. Sec. or Block No.
Lot Size
No. Bedrooms
Garbage Disposal
Auto Dish Washer
Auto Wash Machine
Type Water Supply _
House r Mobile Home
Business
_ U. a s o. in ami y
YES ❑ NO ❑ Specifications ,for. System:
YES O NO ❑
YES 0 NO ❑ f
Speculation
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
1.
a ,
l,
*Contact a representative of the Davie County
9:30 A.M. or 1:00-1:30 P.M. on day of co"
Final Installation Diagram:
mprovements permit by'--
Kp-artment for final inspection of this system between .8:30-
elephone Number: 704-634-5985.
System Installed
Certificate of Completion Date A4 A?A
*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.
provements permit by.,'
*Contact a representative of the Davie County Healt�epartment for final inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day of co ple7t* n. Telephone Number: 704-634-5985.
Final Installation Diagram:
System Installed
_��
r
1
Certificate of Com letion Date.
*The signing of this certificate shall indicate that the system described above as 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.
Permit Number
'��y ,
Name %�' ,.
;j ,. � i,�.,
Date C _ ` ,
Location
\_1
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 ❑
Specifications for System: t .
Auto Dish Washer
YES ❑ NO ❑
Auto Wash Machine
YES b NO ❑
Type Water Sup ly
__
A.
`This permit Void if sewage system described below is not installed within 36 months from date of issue.
{
provements permit by.,'
*Contact a representative of the Davie County Healt�epartment for final inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day of co ple7t* n. Telephone Number: 704-634-5985.
Final Installation Diagram:
System Installed
_��
r
1
Certificate of Com letion Date.
*The signing of this certificate shall indicate that the system described above as 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.