P31067 Cana Rd—.
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
T.o. of Bedrooms te-yt , Date _3 -/'0-6
This permit is granted to for the installation of a septic tank_.
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At the residence of z��-P _meq �1�1c� t Q� Address
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal. Sf?-rJ
Manufacturer's Name d Address :�1'5c x
No. of lines___,/ _width_Zin. Total Length a -D ft. No. of Sq. Ft.
Type of filter material_Total tons used _
Minimum Requirements: House T ailer Tank Cap. Sq. ft. line o
Two-bedroom house 800 600
Three-bedroom house 900 900
No one shall install a septic tank in Davie
or his agent.
Date of final approval
County without a permit from the Health Officer
Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to specifications.
Signed: --
Septic Tank Contractor
I1ote: Make sketch of disposal system on back of sheet and mail to Health Center, Mocksville.
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