P71973 Casa Bella Drive Lot 24DAVIE COUNTY HEALTH DEPARTMENT
Jumer/Occupant
Address&E,
Building Contractor
6_4-5 4 guj� A ;- 2,1_/
SEPTIC TANK PERMIT Date —
To: tA
Address i
Address ,
Cal. Manufacturer's Name
No, of lines �� Width—in. Total length ft. No. sq.. ft.
Type of filter material 2 Total tons used
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 specificatign
e Gx�Signed:
Septi • an Contractor
Note: Make sketch of disposal system onback of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North -Carolina 27028.