P3 Southwood AcresDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Dated —
Jwner/Occupant To- ��/�/
Address Address _2 �Ii�Il
Building Contractor Address %�rc.Aa ,
Cal. �?'O Manufacturer's Name Address fr -f'
No. of lines_ Width _�'Lin. Total length o?o2S� ft. No. sq. ft. De
Type of filter material __,_._ Total tons used ,gyp
Minimum REquirements:; House Trailer Tank cap. 800 Sq. ft. line 400
Two-bedroom house/ _J00 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: -' vayty� c. r
Septic Tank, Contractor
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Boz 57, Mocksville, North Carolina 27028.
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