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DAVIE COUNTY HEALTH DEPARTMENT
Jwner/Occupant
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Building Contractor
SEPTIC TANK PERMIT Date Z/724-91—
To
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Cal. qp 'Manuf to 's Name Address�/���
No. of lines Width in. Total length ft. No. sq. ft.
Type of filter material{. Total tons used
Minimum REquirements: House Trailer Tank cap. 800 Sq. ft. line 400
Two-bedroom house 800 600
Three-bedroom house 900 900
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No one shall install a septic tank in Davie County without a permit from the F?ealth Offic
or his agent.
Date of Final Approval — 2 Signed:
"S46itarian
I hereby certify that the above septic tank has been installed according to specificatioz-
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.