P92872 Southwood AcresDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date
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/ Jxmer/Occupant
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Address�0uf�.ya�� ��ue�LT� /_ Address 2E
Building Address
Cal. ' 0 Manufacturer's Name �� G , Address
No. of lines _� Width � in. Total length /,S- ft. No. sq. ft. �O —/
Type of filter material Total tons used17
_� f}•- ; �—
rliniiium �REquir�me�ts,:)- cHouse Trailer Tank cap. 800 Sq. ft. line 400
_—Two, -bedroom house 800 600
Three bedroom house 900 900
No one shall in a septic tank.jn-Davie County without a permit from the Health Offic
or his agent. 11 1
-Date,.#} Final Approval
I hereby certify that
Signed:
Sanitarian
the above septic tank has been installed according to specificatior
Signed: 13 "e— ��Ge
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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