2178 Hwy 15814
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date)timer/Occupant 1 To:
Address ����, Address
Building Contractor Address ll p
Cal. Manufacturer's Name Address
No. of lines �_ Width in. Total length D ft. No. sq. ft. 3 2-1- a�
Type of filter material L�rP_ Total tons used '
Minimum REquirements: House Trailer ,Tank cap. 800 Sq. ft. line 400
wo-bedroom house 800 600
. r
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 Eanal Approval
Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according tope 'ficatior
tf '
Signed:/,.p
G
Septic Tank Contra or
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.