P80773 Becktown RdDAVIE ,COOUNTY HEALTH DEPARTMENT SEPTIC TANK PEW-1IT Date ( 7
D' mer/Occupant {17`D1-ZiQ •fal 7P S rU
Address A2 Address
Building Contractor �j�, �`�� Address
Cal. '7$'a Manufacturer's Name„�.`, �'i%_� Address %¢
No. of lines l Width L --S in. Total length 16,>o ft. No. sq. ft. �° O
Type of filter material Total tons used /3
Minimum REquirements: House Trailer Tank cap. 47 80,w 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 9 Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to specificatioi
Signed: %21•
Sep is Tan Contractor
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.
C.
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