P7372 McLaughlinDAVIE COUNTY HEALTH DEPARTMENT
J,,mer/Occupant
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Address
Building Contractor
SEPTIC TANK PERMIT Date /Y 9.02
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To:
Address
Address
Cal. Manufacturer's Name Address
No. of lines Width in. Total length �%� ft. No. sq. ft. Js O
Type of filter material Total tons used 3
Minimum REquirements: House Trailer Tank cap. 800 Sq. ft. line 400
600
Two-bedroom house 800
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 installed according to specification
u
Signed'_�
Septic Tank Contr or
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box ocksville, North Carolina 27028.