P61272 Bermuda RunDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date
Owner/Occu ant
Addressl r
Address
Building Contractor , �£A d ess C v
Gal. D Manufacturer's Name ��'� Address
No. of Iines Width Lin. Total length ft. No. sq. ft. �1-2�_Xa
Type of filter material _ Total tons used o? S
Minimum REquirements: House railer 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 specification
Signed : �( %y�✓�"
`\ Septi Vnk ori ractor
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.