P4769 Twin Cedars Golf RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
To, of Bedrooms _ Date=/�%^(� f'
This permit is granted to ` CuJ-�Q ,/� �t�� for the installation of a septic tank_.
at the residence of r �^ Address
Building Contractor Address
Seitic Tank Specifications: Length Width Depth Capacity Gal.
Manufacturer's Name C?s �, 7. S��-co Address_�����d���X�
Tio„ of lines_ width_�/Lin. Total Length __/Eo ft. _b. of Sq. Ft. _4� D,0
Type of filter material OLv CZ�Total tons used c� C>
i11inimiun Requirements: House Trailer Tank Cap. 800 Sq. ft. line x:00
• Two-bedroom house 800 600
Three-bedroom house 900 900
No one shall install a septic tank in Davie County without
or his agent.
Date of final approval
a permit from the Health Officer
Signed:
Sanitarian
1 hereby certify that the above septic tank has been ins ta led according to pec_ifi/cations.
Signed: __'�'tlJ+✓ _M
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center, Mocksvillen