P82771 Hwy 801N DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms /� /Ee, Date L( & dI,
This permit is granted to for-the installation o�eptiT 5
at the residence of ;Address :
Building Contractor e f► /; �, }y(
Septic Tank Specifications: Length Width i Depth Capacity Gal.
V {
Manufacturer's Name Address
No of lineswidthin. Total Length.faro ft. - 'No. of Sq. F
Type of filter material d-�.as -�- Total tons used 301-
Minimum Requirements: House Tra erg -- . .Tank Cap. • '800 Sq. ft. line x+00 j f
Two-bedroom house, `_ "' 800 600 !
Three-bedroom house 900 900
No one shall install- septic tank in Davie County-without a permi from the Health:
Officer or his agent._,_ �.
Date of final approval _ , -. Signed: ? i
Sanitarian
I hereby certify that the above septic tank has been installed according to
specifications. � l
Signed: I
Septic Tank Contractor
i
Note: Make sketch of disposal system on back of sheet and mail to Health Center, ;
Mocksville.
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