P111572 RenegarDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date
Jc mer/Occupant Zi ik cZ 4 To: T , �O �e S f�
Address� �%aC S U+ l 1 F'_ Address 6 ('5,/���
Building Contractor
�i;y-�i`S. 2/t, (Ztr C,sz,,.t Address
Cal. 6 6 Manufacturer's Name 5 %� p q Address
No. of lines % Width _Y:Lin. in. Total length 1&46 � ft. No. sq. ft. p 0
Type of filter material _Rin ./ '2Total tons used
Minimum REquirements: House Trailer Tank cap. 800 Sq. ft, line 400
Two-bedroom house 800 - 600
Three-bedroom house C00>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 r
Signed:
Sanitarian
I hereby certify that the above septic tank has been installed accordin to speci 'catioi
Signed: �, ,
Septic Ta-ontracto
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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