P72673 Edgewood Cir DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date —2 6 '3
Owner/Occupant To:
Address Address
Building Contractor _ �,�,,,,�¢, Address Z
Cal. Manufacturer's Names f %, ? Address
No. of lines _ _ Width �n. Total length r�1r2y ft. No. sq. ft. --�gob
_—
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
I hereby certify that the above septic tank has been installed according to specification
' Signed: 060 L4 cc"LZf
'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.
°;,,
._ � . , . _ _ � ,. y. � n
_ � ..
_. _ .. . .. v � . .. �
. .
� �
a
o ._ _.. _ _ _ __
_ ._._ __ .
.___ __ _
,. �
�;_ . ..
D