P8972 WhitakerIJ 4
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date'
Jcmer/Occupant r. jc,��cL�/�?-��, To:
,'Address Address
Building Contractor Address c
Cal. o v Manufacturer's Name Address
No. of Lines �_ Width in. Total length ft. No. sq. ft. •� - —�—
Type of filter material t �Dac�, Total tons used
Minimum REquirements: House Trai er 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 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 57, Mocksville, North Carolina 27028.