C W TuckerDAVIE COUNTY HEALTH D PARTMENT SEPTIC TANK PERMIT Date -3 c)
Jwner�t �� To: Aa
Address
� � Address
Building ContractorAddress
Cal. Manufacturer Is Name ae.0 `v ,% r F� ' Address
No. of lines �� Width n. Total length 1 ft. No. sq. ft.
Type of filter material Total tons used �Lo
Minimum REquirements: House Trailer Tank cap. 800 Sq. ft. line 400
Two-bedroom house uk
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 specificatio?
Signed: e_5�
Sep Contractor
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.
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