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2148 Davie Academy Rd
DAVIE C�0 WTY HEALTH DEPARTb4ENT SEPTIC TAN PERMIT Date D Owner/OccupantJU To : S-, 7, Address Address Building Contractor Address —T— Cal. Manufacturer's Name c �1 Address No. of lines Width ^in. Total length / © � ft. No. sq. £t. Z e Type of filter material sin/2(e Total tons used p2 �p7 lslinimum REquirements: [louse 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 installe according to specificatior Signed: �- ^ 3 Septic Tank Cont . or Note: Make sketch of disposal system on back of sheet and mail to Davie County Health Center, Box 57, Mocksville, North Carolina 27028. r v �