P71973 Casa Bella Drive Lot 23DAVIE COUNTY HEALTH DEPARTMENT
Owner/Occupant
-Address aA";�
Building Contractor
Cal. a Manufacturer's Name
SEPTIC TANK PERMIT Date
To:
Address
Address
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No. of lines / Width 7?& in.' Total length %S� ft. No. sq. ft. C OZ�
Type of filter material Total tons used a
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:
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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