P62273 Wood Valley Lot 21Ba/
DAVIE COUNTY HEALTH DEPARTMENT
3wner/Occupant
Address —
Building Contractor
Cal. 4anufacturer's Name
No. of-etines Q width 3D
Type of filter material
SEPTIC TANK PERMIT Date
To: —AW-70—
Address
Address 11
ress
Total length a ft. No, sq. ft. 3 az, a
Total tons used o7 S
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 sp
ecification
Signed:c
'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.