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P62173 La Quinta Lot 7BDAVIE COUNTY HEALTH DEPARTMENT Owner/Occupant Addres:�q _ _ ` Building Contractor Cal. o © Manufacturer's Name g.0 SEPTIC K PERMIT Date _ �2 To: .161 1161 Address x/11 'sr _.Y� Address — f s r- . v No. of lines �` Widthin. Total length ��3 ft. No. sq. ft.b'� T Type of filter material Total tons used 33 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: Se is 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. �' ,. � a t `