P101072 BoggsDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date
Sumer/Occupant ;. - -�,n To : ,
,'Address � Cz Q � ''�
�--- Address ,
Building Contractor Address
F
Cal. 'e-) Manufacturer's Name Address
No, of lines Width _Y;L/in. Total 4ength ft. No. sq. ft.
Type of filter material 7*1n y Total tons used _-7 D — '? -Z--
Hinimum REquirements: house Traile 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 tie above septic tank has been installed according to specification
Signed:
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.
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