209 Granada Drive Lot 68-BDAVIE COUNTY HEALTH DEPARTMENT
)i+mer/Occupant
Address
SEPTIC TANK PERMIT Date /�_ 7o —I a
To:
Address
Building Contractor Address t
Cal. n n Manufacturer's Name Address
No. of lines _ ` Width 3CP in. Total length 1 ft. No. sq. ft.
Type of filter material �_ Total tons used
J- -
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 instal ed according t ecificatior
Signed: o , ,-,,-"
Septic Ta9k Contr ctor
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.