P090773 Hickory HillDAVIE COUNTY HEALTH DEPARTMENT
Owner/Occupant
SEPTIC TANK PERMIT Date 2Z71
To:
Address ��s t�.��f Ty C'1� Address ��' -iLLi
Building Contractor f,r�/ _� _� �`iv_ Address
Cal. -7go Manufacturer's Name �},��-�� Sr.- 7'-'- Address
No. Iof lines r J Width 44r in. Total length , " ft. No. sq. ft. �4
Type..of filter material Total tons used .7e
Minimum,ftEquirements: 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 specificatioT
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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