P8773 La QuintaDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date u37
Owner/Occupant To: ¢
Address _ Address al
Building Contractor Address —�
Cal. Manufacturer's Name (Address
No. of lines / Width jin. Total length 43 d ft. No. sq. ft.
Type 'o£ filter material Total tons used oZ
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
11
Signed:
Sep 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.