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DAVIE COUNTY HEALTH DEPARTMENT
Sumer/Occupant g-2
Address 14 � v,
Building Contractor
Cal. Manufacturer's Name
SEPTIC TANK PERMIT Date
To:
Address
Address
Address
No. of lines Width --in. Total length
Type of filter material Total tons used
Minimum REquirements: House Trailer Tank cap.
Two-bedroom house
Three-bedroom house
ft. No. sq. ft.
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 specification
Signed:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box S7, Mocksville, North Carolina 27028.