138 Center Circle Lot 29DAVIE COUNTY HEALTH DEPARTMENT
JHmer/Occupant
Address
iti
Buildiinn Contractor P7.7 iyel el,
cal. / � 6 Manufacturerts-Name_P&P e
No. of lines%� _ dth in. "T'ot l�l
Type of filterr"M'at�erial /o 5Tr"9
Minimum REquirements: House Trailer Tank
Two-bedroom house
Three-bedroom house
No one shall install a septic tank in Davie
or his agent.
Date of Final Approval
I hereby certifyJthat the above septic tank
S P C;N--T"ANK'PERMIT Date
To: _: e7i
Address'- .✓�iP
Address .:�/ldClf
ddres§, Sf}snG
ength ft. No. sq. ft. o o
Total tons used
cap, 800'-,,' -,Sq. ft, line 400
800 .;` ,, 600
900 900
County.without'a permit `,from the Health Offic
Signed:
Sia Marian
has been installed according to spec'.icatior
Signed:
Septic T nk Contractor,.
Note: Make sketch;of disposal system on back of sheet and mail to Davie County
Center, Boz 57, Mocksville, North Carolina 27028.
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Health
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