P91873 Sonora Drive Lot 58DAVIE COUNTY HEALTH DEPARTMENT
Owner/Occupant
Address
b
Building Contractor
SEPTIC T K PERMIT Date
To:
Address (�� s-,
Address
Gal. cry Manufacturer's Name ( d reds 7-1
No. of lines +� Width 9 in. Total length /3,3 ft. No. sq. ft.
Type of filter material c _ Total tons used O
PIinimum 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 specificatior
Signed: J'a
Septic -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.