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P71973 Hwy 801SDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PEW4IT Date / c D mer/Occupant mac` !1 c , To: ,'Address �p® �P7?P� Address Building Contractor Address Gal. 2RD manufacturer Is Name , � �/ ��� Address 'Io. of lines / Width _��in. Total length o?d )_ ft. No. sq. ft. Vg -d 'type of filter material cQ 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 according to specification 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. d ��