P1273 Eaton Church RdDAVIE COUNTY HEALT DEPARTMENT SEPTIC TANK PERMIT Date
Jumer/Occupant To
,'Address 7 Address
Building Contractor :.,� Address
Cal. �%i,*�� manufacturer's Name Address
No. of lines Z Width ,in. Total length ,ft. No, sq. ft. Xv-
Type of filter materialsTotal tons ued
?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 according to specification
D Q.
��(� 10
i2g Signed:[,�� .
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.
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