344 or 2220 Angell RdDAVIE COUNTY HEALTH DEPART NT SEPTIC TANK PERMIT ��Da�te _3 —Z11— � ,�
Dumer/Occupant ' _ To: ( & c
Address%�4 .
Address
Building Contractor �,,�a. Address 'T
CalManufacturer's Name Address . �`
�' ..� ;��--�-+-roc Ctrl,
No. of lines _�_ Width in. Total length �� p ft. No. sq. ft.
Type of filter material.'&) -J-3 r,w Total tons used ,f'p
Hinimum REquirements: [louse 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 according to sp
ec
ification
Signed:L
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.