751 Markland Rd (2) DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms E/11 - Date
This permit is granted to AV -, for the installation of a septic tank _
at the residence of AA,JlA..L,,AA Address &,;t,
Building Contractor Address
Septic Tank Specifications: Length y Width _ O
_ 0
Manufacturer's Name Address
No of lines� width�j, in. Total Length `ft. No. of Sq. Ft.
Type of filter material ; . Total tons used _ LS-
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 according to
specifications.
Signed:
Septic Ta Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
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