P101273 Hwy 601SDAVIE COUNTY HEALTH EPARTMENT
SEPTIC ,TANK PERMIT
Date
Oc+mer/Occupant
To:
Address, !��►_��Ol
Address 7�T¢
BuildingContractor �—
.---����
Address
Gal. Manufacturer'sNam �—�o
�, j ,� , Address.
NQ. of lines Width in. Total
length ft.
No. sq.
ft. a d
Type of filter material':1
Total .tons used
/41{—
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 according to specificatioT
Signed:
Septic TaAk Contractor
Note: Make sketch of disposal system on back of sheet and mail to Davie County Health
Center, Box 57, Mocksville, North Carolina 27028.
� f
�..
�_ �