349 Ben Anderson Rd (2)DAVIE COUNTY HEALTH DEPART11ENT SEPTIC TANK PERMIT
No of Bedrooms ac Date /a ^ /J�- % l
This permit is granted o _ for the inst lation f a septic tank
at the residence of (tggAq Address 7( x -1o()
Building Contractor Address
Septic Tank Specifications: Length Width `_Depth Capacity Gal. 'U'b
Manufacturer's Name _6-C Address �j 3
No of nesTridth in. Total;Length Sift. No. of Sq. Ft. cS'd
li
Type of filter material /D GSTotal tons used / 7
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Toro --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:
is Ta ontractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
, - i .. -. , � .., a 11 - �