P30172 Howell Rd :---DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT-- .
No of Bedrooms Date - /- / 2
This permit is granted to for the installation of a septic tank
at the residence of Address D � S gs-a
Building' Contractor reg s �?TV
Septic Tank Specifications: Len Width `Depth �',,tCapacity Gal.
Manufacturer's Name Address-,
No of lines width in. Total Length ftrf' No. of Sq. Ft.
Type of filter material tTotal tons used
Minimum Requirements: House TrailerL Tank Cap. ; 800 Sq. ft. line 400
Two-bedroom hous 1 0060
Three-bedroom house 900
No one shall install a septic tank in Davie County without a permit from the Health
Officer or his agent.
Date :of final approval ` ' - Signed: _
Sanitarian
I hereby certify that the above septic tank has been installed according to
specifications.
Signed:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
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