556 Redland Rd (2)DAVIE COUNTY HEALTH DEPARTMENT
)caner/Occupant it , F}.
�'� am
Address � /,g
Building Contractor
SEPTIC TANK PERMIT Date "3 l—') 3 -
To: To:
Addressi
.Address
Cal.- Manufacturer's Name �-
! Address
No. of lines _�_ Width 3 n. Total length 7S ft. No. sq. ft. ,2�
Type of filter material
Total tons used
Minimum REquirements: House Trailer Tank cap.
Two-bedroom house
Three-bedroom house
F�
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 acord* g toys ecifi a 'ox
Signed:
Septic r nk Contractor
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box S7, Mocksville, North Carolina 27028.