146 or 274 Daniel Rd DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No, of Bedrooms 62 _ Date l _
This permit is granted to for the installation o a septic
at the residence of Address 4-L r
Building Contractor V Address
Septic Tank Specifications: Length Width Depth Capacity Gal.
D:Lmufacturer's Name 2 -Q r�'.%; C Address �( I pzLv�k
No, of lines-widthIK in. Total Length S� ft. No. of Sq. Ft. 1,6)o
Tem,e of filter material /o Total tons used /J�
Mi.nimim Requirements: House Trailer Tank Cap. 800 Sq. ft. line 1+00
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 been installed according to specifications.
Signed: t'
Se c Tank Contractor
:dote: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksville,
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