P81672 Bermuda RunDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date u 91Z
Jwner/OccupantTo:
Address c% _ Address
Building Contractor f7So12 Address
Cal. p p Manufacturer's Name & 6-Q, L7_47 Address /�ic�7 r
No. of lines 3 Width 3 6 in. Total length Zb � ft. No. sq. ft.
Type of filter material !o Total tons used 671
Minimum REquirements: 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 cc ding to specific t 0
Signed:
ptic Tank Co tractor
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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