6802 Hwy 801S (2)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date
Dwner/Occupant ��T
Address_�l
To:
Address
Building ContractorL1
Address
Cal. ' Manufacturer's Name �„z�i�� SF,�� ��7`��iY dress 2ntZ4-
lines in. Total length ft. No. sq.
ft. FLIZ—? – 1A
No. of _L—Width
Type of filter material jam,
Total tons used
'P
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 r
Signed:
Sanitarian
I hereby certify that the above septic tank
has been installed according to specification
Signed:°
Septic 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.