P72073 Casa Bella Drive Lot 25�-sq- SL ---.LL- L-0--rz�
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date d --?3.
Owner/Occupant To: Y_
AddressQj�02�X �f Address
Building Contractor Address
Cal. D B ManufacturerIsName �c dress
No. of lines �_ Width _in. Total length Q ft. No. sq. ft. n
Type of filter material Total tons used a�7
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:,
Sept' 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.