P82873 Walt Wilson Rd DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date
Owner/ c pant
Ad ress � /,/�1�,, _ Address
Building y �iLe Address
Cal. Manufacturer's Name K�e,,_Zp Address
No. of lines — Width �in. Total length ft. No. sq. ft.
I y�
Type of filter material Total tons used l l_
Minimum REquirements: House Trailer Tank cap. 800 Sq. ft. line 400
Two-bedroom house 800 600
Three-bedroom house 900 900
No one shall install a septic tank in Davie County without a permit from the Health Offic
or his agent.
Date of Final Approval Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to specification
Signed:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.
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