P5168 Greenhill Rd DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
Vo. of Bedrooms r-- Date
`i'his permit is granted to „ for the installation of a septic tsLs;
at the residence of 61 � e� u,��C1_ Address r`� 7`� /a ,s �fur cL+�IM,
y
Duiiding Contractor Address
Septic Tank Specifications: Length �) Width Depth Capacity Gal. g " 0
Manufacturer's Name �.t-�� �,�. /. C Address r
No, of lines I wiath_.�n. Total Length __tZn ft. No. of Sq. Ft. �Zr'y
Type of filter material o c!. Total tons used .o v
Minimum Requirements: House Traile 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 Officer
or ;:.is anent.
Date of final approval Signed:
Sanitarian
lzexcby certify that the above septic tank has been ins t _led according to s fcifications.
Signed: )1J1.
Septic Tank Contractor
Note Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksvillep
1 �
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No. of Bedrooms Date S� ^6
This permit is granted to for the installation ofa septic ta_:
at the residence of _ Address
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal. o
Manufacturer's Name ^� K�c�-�P �• , (� Address c ra c
No, of lines__L_width�in. Total Length /OD ft. No. of Sq. Ft. :zzsa
Type of filter material o Total tons used j,3./� �
Minimum Requirements: House Traile3V 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 Officer
or his agent.
Date of final approval Signed:
Sanitarian
I hereby certify that the above septic tank has beeninst .led accordin to s ecifications.
Signed:
Septic Tank Contractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksvilleb
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