P673 Redland RdDAVIE COUNTY HEALTH DEPARTMENT
SEPTIC TANK PERMIT Date�v�� �3
Owner/Occupant �Q d w-11aws
To:
Address AWL �J.s- Z' V(/0 )
Address
Building Contractor
Address
;al. n Manufacturer's Name
_ Address
No. of lines �Z Width -il-Zin. Total
length f -s"6 ft. No. sq. ft. d o
Type of filter material Gz) -Y4
Total tons used 01-7
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 specificatioj
Signed:42
Septic Tank Contractor
Note: Make sketch of disposal system on back
of sheet and mail to Davie County Health
Center, Box S7, Mocksville, North Carolina
27028.
IJP