P72373 Casa Bella Drive Lot 21g' F CASA @z� 9af2- car 2-1
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date
Ohmer/Occupant To: �c-G
Address P/, A(6/0 At Address r }sem , , � l,A
Building Contractor Address
Cal. a Manufacturer's Name
`�Ad ere
No. of lines �` Width 3!� in. Total length T --'p ft. No. sq. ft. a !yo X
Type of filter material SA_Total tons used
Minimum REquirements: House Trailer Tank cap. 800 Sq. ft. 1 ne 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
00,
• Signed:..
Sep 'c 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.
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