P101673 C C LeonardDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERP,1IT Date 3
To :
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Jtimer/Occu ant a X .
Address Address _X��Yr 0-�
Building Contractor utI Address
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Cal. d Manufacturer's Name Address 3
No. of lines _�_ Width _�? (iin. Total length 1,3 ft. No. sq. ft. a�
Type of filter material Total tons used
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
1
I hereby certify that the above septic tank has been -,installed according to specification
S4Rned
\.F Septic Tank Contrac r
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.