P32870 Fostall Drive Lot 28r
DAVIE COUNTYf HEALTH DtPQRTMENT SEPTIC TANK PERMIT Date 3-- 29'— %j3
)caner/Occupant To: �� . (/ ✓ arz�s, �ar
lddress1r� %4��7r Address Aj
Building Contractor uAe 41Z Address
Cal. ao Manufacturer's Name XX6 Address PK 3 40
i
` oto: of lines. � � Width -,Weiin. Total length / j � ft. No. sq. ft.
Type<of filter material r p Total tons used
Minimum.REquirements: douse Trailer Tanl cap. 800 Sq. ft. line 400
- _ Two-bedroom house 800 600
Three-bedroom house v 900 900
''No.one shall install a septic tank in Davie�County without a permit from the Health Offic
or his agent.
fa
Date of Final Approval Signed:
1� Sanitarian
I hereby certify that the above septic tank`r.'has been installed according to specification
._.; Signed:
Septic Tank Contractor
Note: Make sketch of disposal systemoon,bac of sheet and mail to Davie County Health
Center, Box 57,- Mocksville, North C"t lina 27028.
a,
D C5��1���
b
^
3
aC
ILf
s