108 Center Circle Lot 3303
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms Date A,0
This permit is granted to 9� a,.w Por the i tallati n of 4 tic tank
at the residence of Address
Building Contractor" Address '!
Septic Tank Specifications: Len Width _Depth pacity_ Gal. 9,F-6
Manufacturer's Name /� �u� �' , /�� �i Address
No of lines _ widthn. Total Length .2 a Jft. No: of Sq. Ft. p db
Type of filter material .�S.e Total tone used g
Minimum Requirements: House Trailer' Tank Cap. 800 Sq._ft. line 400
Two-bedroom house 800 j 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: o ��
eptic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville. - -
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