P31373 Edgewood Cir DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date 3 e7/,� �� 3
Owner/Occupant To:
Address F—d4 c.jdad ;rc% _ Address
Building Contractor `� Address
Cal. Manufacturer's Name7�ttFA,.,� ^ Address
No. of lines _�_ Width -5e n. Total length c>*2oZ S 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 90
No one shall install aseptic 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 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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