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DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PEWIT Date 43—
Dimer/Occupant Q 4 117 1ec'it7_ To: . rdY-zil I . /
c
,'Address Address
'� Address
Building Contractor /
Cal. 9,00 Manufacturer's Name e� Address
No. of lines �_ Width n. Total length_, /dD ft. No. sq. ft. ap
Type of filter material 14 Total tons used
Minimum REquirements: House Trai er Tank cap. 800 Sq. ft.`l,' e 400
600
Two-bedroom house 800 '
Three-bedroom house 900 900
No one shall install a septic tank in Davie County without a permit from the Health Officl
or his agent.
Date of Final Approval
Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to specification
Signed:
Septic Tank Contractor
Note: Male sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.