P91873 Casa Bella Drive Lot 30DAVIE COUNTY HEALTH DEPARTMENT SEPTIC RNK PERMIT Date
Owner/Occupant To:
Address
� Address
Building Contractor Address
Gal. �'A Manufacturer's Name
No. of lines `�_ Width _3 �, in. Total length �16 ft. No. sq. ft.,? p /
�r
Type of filter material Total tons used C.-)52,
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: h _.
SCRCic 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.