P32373 LaQuinta Lot 2DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERPIIT Date
103 –
Owner/Occupant To:
Address
--_r� , Address3
Building Contractor 12PI Address
Cal._ Manufacturer's Name Address r . C�
es r
No. of lines ��� Widthin. Total length /,3S ft. No. sq. ft. no
Type of filter material �2 t— Total tons used X02
Minimum REquirements: House Trail r 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 spe ificatioi-
Signed: zl�1
Septic Ta o tractor
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.