Bermuda Run Job #10DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date
Jcmer/Occupant To: T.� / �� r
Address Rux� �- Address
Building Contractor Address
Cal.,/,;?,S—,0 Manufacturer's Name e. � � Address /.J1 'S",
No. of lines _ Width _J�Ojn'. Total length ft. No. sq. ft.
Type of filter material �%a,/D .�9 •rL•' _ t. Total tons used 1p' -
Minimum REquirements: 711ouse Trailer Tank -cap... 800 Sq. ft. line 400
Two-bedroom house " 800 600
Three-bedroom house 900 900
No one shall install a.septic_ta_nk__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: LR.�
Se tic 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.
/.a, s—v Aqtik