P22173 Hwy 601NDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date
Otimer/Occu ant To:i
f f sem'` �; /,.$/ _
Address
��- Address
Building Contractors J J('j Address
CMal. � c> anufacturer! s Name \ ,� r`Lrz — Address
No. of lines _ _ Width e'en. otal length ,� p n 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
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 ccording to specific or.
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.
0
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT Date
Omer/Occupant _ To:
Address: u / Address
uV /�,� 1
Building Contractor � ��J Address A t
T
G,a1. %
OU Manufacturer's Name ` c Address
No. of lines _� Width ��in. otal length ft. No, sq. ft. elo a 2L/
Type of filter material Total tons used
Minimum REquirements: douse Trailer Tank cap. 800 Sq. ft. line 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 Offic
or his agent.
J
Date of Final Approval
Signed:
Sanitarian
t
I hereby certify that the above septic tank has been installed ccording to specific 'or
T Signed:
l Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
`l Center, Box 57, Mocksville, North Carolina 27028.