P21467 Woodlee Dr DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
a, of Bedrooms ► Date
':his permit is granted o � .v�, /, �o for the installation of a septic tank-
at the residence of Address
Building Contractor ��,�._rs + � cfv-,,� Address
Septic Tank Specifications: Length Width Depth Capacity Gal. _11-0 6 r
Manufacturer's Name -._Z ! ..__ Address
No. of lines widthin. Total Length _ ddaft. No. of Sq. Ft.
Type of filter material rte. Total tons used _20,/,o
Minimum Requirements: House Atailer Tank Cap. 800 Sq. ft. line I�
Two-bedroom house aaQ
Three-bedroom house 90 900
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 certif`j that the above septic tank has been installed ac )rding to s ecifications.
Signed:
Septic Tank Contractor
Note: Make sket h of disposal system on back of sheet and mail to Health Center, Mocksville.
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