P10473 W C Hairston/T F MeroneyD 1E UNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date
Owner Occupan C.' ( f7`Q: rs To
Address C;us.. Address
Building Contractor Address
vO Cal. Manufacturer's Name Address
fl
No. of lines Width in. Total length ft. No.'sq. ft.
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 aseptic tank in Davie County without a permit from the Health Offi,,
r 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.
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