Erwin Mills - Hickory St ,COU ut"tom GUiN MW15.
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
' �., of Bedrooms Date 1c1 .P so '
This permit is granted to for the instAlation of a septic tan
at the residence of ' Address
444
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity�Gal.
Manufacturer's Name Address
No., of lines width in. Total Length ft. No. of Sq. Ft.
Type of filter material 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-bla't tank in Davie County aitrlou�°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 sketbi. of disposal system on back of sheet and mail to Health Center, Mocksville.
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