P61473 Hwy 801S - Duke Power SubstationDAVIE COUNTY HEALTA DEPARTMENT SEPTIC TANK PERMIT Date,(, _t1 — l
Owner/Occu ant
r.
Address Address 7P6 �(
Buildingntractor Address
Cal. �?J*P Manufacturer's Name �� Address LC)
No. of lines _�_ Width �in. Total length 6"0 ft. No. sq. ft. jd O
Type of filter material Total tons used 2)I-- 3 0
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
Signed:
etice_�Tank �Contr�actor�
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.