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DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms Date ` D o
This permit is granted o 1� for the installati n of a se is tank
at the residence of`2��;_ Address��.�i�. , /G r f✓�
Building Contractor / Address
Septic Tank Specifications: Length Width Depth Capacity Gal.
(1 19
Manufacturer's Name c>'lL�? Address, t.
No of lines width Goin. Total Lengthft. No. of Sq. Ft.'s n
Type of filter material` Total tons used
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line x+00
Two-bedroom house 00 00
Three-bedroom house 900 900
No one shall install a septic tank in Davie
Officer or his agent.
Date of final approval
County without a permit from the Health
Signed: _
Sanitarian
I hereby certify that the above septic tank has been installed according to
specifications.
Signed: t
Step is Tank ontractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.