150 Adams Rd (2)DAVIE COUNTY HEALTH //DEPARTMENT SEPTIC TANK PERMIT Date
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Cal. Manufacturer's Name Address
No. of lines _�_ Width in. Total length o2?Sft. No. sq. ft. O D
Type of filter materialTotal 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 Firal Approval 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.