P111672 PeeblesDAVIE COUNTY HEALTH DEPARTMENT
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Building Contractor i
Cal. Manufacturer's Name
A e/00 0,
No. of lines' Width -L—in. Total
Type of filter material
t
Minimum REquirements: House Trailer Ta
Two-bedroom house
Three-bedroom house
SEPTIC TANK PERMIT Date
To: c�_ y LC/ S'. 7, (�g r
Address
Address
Address
length 00 ` ft.,No, sq. ft. �D
Total tons used 7_4W S
nk cap. 800, Sq. ft, line 400
800 600
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 pecificatior
Signed: (�124�✓1
Septic Taf 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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