P32472 MyersA9
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date 3 — — oZ
Jwner/Occupant�l��'w�-ri1� T- To:�
Address
Address
Building Contractor �/,JLa,�:'iL Address
Cal , j,,7j Manufacturer's Name -4-/), Address
No. of lines_ Width •'-'n. Total length j c5?5 ft. No. .sq. ft.
Type of filter material,�U,',yw� Total tons used j
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 install/ed a9cording to specification
�L'J.-i; I-,�' � 1j''
Signed: t✓V
Septic Tank�'Pontractor
Note: Make sketch of disposal system on back of sheet and mail to Davie Counff
Center, Box 57, Mocksville, North Carolina 27028.