1975 Hwy 158 DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
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No of Bedrooms o� /ra i<lc�s a h Date _L.:Z
This permit is granted to k4 -Ok or the installation of a se tic tank
at the residence of ✓ ` ar` Address
Building Contractor Address
Septic Tank Specifications: Length Width Depth Caappaaciity Gal. f fiy-PS
Manufacturer's Name Address
No of lines_ width i Total Length o26ft. No. of q. Ft/.
�a o
Type of filter material Total tons used o2-s—
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 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 accords to
specifications.
Signed: L �
Septic ank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
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