P8772 CarterQ
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date
e SJcmer/OccupantCr
Address 74
Address
Building Contractor �� Address
Cal.�� Manufacturer's Name(7, Address �� 41— Llv tt �,
No. of lines ---�-- Width Y in. Total length �O � ft. No. sq. ft. a �
Type of filter material La ?mil :, Total tons used 3
Minimum REquirements: House Trailer // Tank cap. 800 Sq. ft. line 400
Two-bedroom house 800 600
f` 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
Signed:
Septic Tani( Contractor
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.