1014 Wyo RdDAVIE COUNTY HEALTH DEPARTMENT
Jwner/Occuppant
Address eL'f'
Building Contractor
Cal. Manufacturer's Name
SEPTIC TANK PERMIT
To:
Address
Address
No. of lines Width yin. Total length
Address
Date /—,3/— � s
ft. No. sq. ft.
Type of filter material Total tons used
Hinimum REquirements: House Trailer Tank cap. 800 Sq. ft. line 400
Two-bedroom house 800 600
Three-bedroom house 900 900
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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.
0
HEALTH DEPARTMENT WATER AND/OR SEWER PERMIT
T 0 CZ �L �.S ^!� r(
Applicant
�r
This letter is to serve as a
V
1. Permit to INSTALL acceptable water and/or sewer system (s)
as indicated below:
Water
Sewer
The water and/or sewer system (s) to be installed is (are) subject
to fin�al�in pection and approval before the mobile home is occupied.
2. Permit to use EXISTING water ) (sem t
Yewer s
or and/ � system as in
cat�,ed/below:
Water
Sewer
The lot address or description is as follows:
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Signed this IAA day of
BY: c e_4 0,
P int Type
C
whose position with the(I Q�6�' �L,4 health Department is
Y` c�Q rL
�/ Signature