146 Fostall Drive Lot 13/W# /3
DAVIE C LINTY HEALTH /DEPARTMENT
Jwner/Occupant I /i� L ,
Address
Building Contractor
Cal. 9—= Manuf�
No. of lines _CN�
Type of filter material
SEPTIC TANK PERMIT Date•—
Total
Minimum REquirements: House Trailer Tank cap.
Two-bedroom house
Three-bedroom house
tons used C33 7-,3Z
800 Sq. ft. line 400
800 600
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 specificatior
Signed: Q. /'J' �.'_
ep is Ta Contrac
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box S7, Mocksville, North Carolina 27028.
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