P8873 La Quinta (2)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC ANK PERMIT Date r
Demer/Occupant To: `
Address Address
Building Contractor LIQ Address j
f
Cal. eaD Manufacturer's Name. � Ad ress /1
No. of lines �` Width3�in. Total length p _ft. No. sq. ft.
Type of filter material Total tons used 67 02
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: �� _a.�4
Septi ank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.