Hobson, JohnnieDAVIE COUNTY HEALTH EPARTA4ENT
Oi&mer/Occupant t �
Address
Building Contractor
SEPTIC TANK PBRIT Date
To:
�
Addr ss
Address
Cal. Manufacturer's Name . .-` �
Address
No. of lines Width�' - in. Total length
',�i'� ft. No.�sq.t.
���E�
Type of filter material _4�.1D 3_ Total
tons used
Jar
Minimum REquirements: douse Trailer 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:���'
66e tic Ta k ContractYr
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.