P7673 Sonora Drive Lot 49DAVIE COUNTY HEALTH DEPARTMENT
Jwner/Occupant
Address
Lam- I+g
SEPTIC TANK PERMIT Date
To:
Address
Building Contractor Address
ed
Cal. Manufacturer's Name � `-�p�� dress
No. of lines � Width 3(:�,in Total length 3_1 ft. No. sq. ft. 3�
Type of filter material sZ Total tons used o7,3
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:
. Sepvrc 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.