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1036 Riverbend Drive Lot 103Note: Make sketch of disposal system on back of sheet and mail to Davie County Health, Center, Box 57, Mocksville, North Carolina 27028. L DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date • O mer/Occupant _ To: 4 Address Address ja_� Building Contractor Address Gal. ZD ©— Manufacturer's ame Address No., of lines Width Total length a�� t. No. sq. ft. Typo of filter material Total tens used y Hinimum REquirements: House Trailer Tank cap. 800 Sq. ft. line 400 Two-bedroom house 800 600 Three-bedroom house 900 900 �. 7 / ac o No one shall install a sepfic 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 instal according to specification Signed: eptic Ta k Contractor Note: Make sketch of disposal system on back of sheet and mail to Davie County Health, Center, Box 57, Mocksville, North Carolina 27028. IA 1 V IJ 02,/� /-,� e Pe d jo, - r �, (4 � ( 7 -,,, & ,