P92871 Sheffield ParkDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms Date 2?S 7
TAis permit is granted to-�a.xp SST, �'a, for the ins allati o a ep is tank
at the residence of Address '
Building Contractor—b-Ao-t!p gL6 (a,&ddress d
;Septic Tank Specifications: Length Width_. Depth_ Capacity Gal.
"Manufacturer's Name Address
s -
No of line_ width in. Total Length. ft. No. of Sq. Ft. y O O
;Type of filter material .._ Total tons used O
Minimum Requirements: House Trai r 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
11,hereby certify that the above septic tank has been installed according to
,specifications. (\I
Signed.
"e&
eptic Tank Contractor
i
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
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