P83073 Bermuda RunDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date '57 rj�> p
Owner�aa�t Q To : �r 'C r r
Address 'L?eru2u4a k Address 1�� 9 L
Building Contractor Address
Cal. b4anufactu4's Name - 4(Address j�
No. of lines �- Width in. Total length /P -ZS— — ft. No. s ft.,3
Type of filter material Total tons used
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 according to specification
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Signed: GIaV`
\f 6eptflc.'M;k Co actor
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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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