P51173 Howardtown RdDAVIE COUNTY HEAL
Jumer/Occupant
Addres
Building Contractor
Cal. Manufacturer
DEPARTMENT SEPTIC TANK PERMIT Date
jztl1 To: oi,% 4�
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Address %
Address
NameAddress
No. of lines _�� Width _a_(_in. Total length ft. No. sq. ff.
Type of filter material A Total tons used �3oZ
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 Signed:
Sanitarian
I hereby certify that the above septic tank has been installed accor in to specification
Signed:
epti ank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.
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