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142 Bean RdS 10 C) T yo CY? DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date -3 0 /.3%�1l, % Owner/Occupant WAr'Iil F��1 5 To: j� � e %, 7-19l4i Address ,%'t �'fG-%�l�c_lCSv�/�P--- Building Contractor 6) w,-i Address Address 70e 1�S 6? .t- l Cal. �, © Manufacturer's Name �4(1, �,�I/,c %yet/` Address y�� -e' '10, of lines Width in. Total length �L D < ft. No. sq. ft. Type of filter materialiU Total tons used 2 -- 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 installed accordin toj� ecificatioi Signed: Septid 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.