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Mary Ann Howell - AdvanceDAVIE-COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date // _ /-4,l— 13 Jamer/Occupant)"%' To: 0z Address C9, , Address Building Contractor Address Cal. _T Manufacturer's Name=41(&4 Address No. of lines _Z __. Width � �in. Total length /�j S ft. No. sq. ft.--32u — ' �• Type of filter material Total tons used pz Minimum REquirements: House 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'Pereby certify that the above septic tank has been installed according to specification Signed Septic Tan c Con ractor Note: Make sketch of disposal system on back of sheet and mail to Davie County Health Center, Box 57, Mocksville, North Carolina 27028. � U i� 49� rL>