P111672 Edgewood Cir DAVIE COUNTY HEALTI DEPARTMENT SEPTIC TANK PERMIT Date
Okmer/Occupant , 0/%1 To
1 c
Address Address
Building Contractor Address
Cal. _ Manufacturer's Namee�,,t p �,Lj Address
No. of lines _�_ Width _16n. Total length ft. No. sq. ft.
Type of filter material X-cay,D Total tons used a
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 hereby certify that the above septic tank has been installed according to specification
Signed:
Septic Tan eon—tractor.
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.