P81073 Hwy 601SDAVIE COUNTY HEALTH EPARTMENT SEPTIC TANK PERMIT Date D /
Owner/•AEeTo: �r4 .� J� m <S : �` (�G f tm ` u Y` 2r v
Address -4 Address d
r.
Building Contractor Address
Cal. �� Manufacturer's Name �—� Address
No. of lines ` Width _z:L(/in. Total length 43 ft. No. sq. ft.
Type of filter material/a 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 Offi:
or his agent.
Date of Final Approval Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to specificatio,
Signed:,0D
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.
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