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Gladstone MH ParkDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PER,1IT Date' ),Amer/Occupant - To:c lddress Address > Building Contractor �»- Address 'Gal.Q Manufacturer's Name __,Lj ,l , Address No. of lines Width i4g' in. Total length t 1 ,-D ft. No. Type of filter material Hinimum REquirements: -r Total tons used House Trailer Tank cap. Two-bedroom house Three-bedroom house sq. ft. �'00 2� 800 Sq. ft. line 400 800 600 900 900 No one shall install a septic tank in Davie County without a permit from the Health Offic or his agent. Date of Final Approval S Signed: Sanitarian I hereby certify that the above septic tank has been installed according to specification D7 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. �� j; �� / � s �— 1a y .,,, '�.� �. �� © -- �. G / 1