349 Ben Anderson Rd (3)DAVIE COUNTY HEALTH DEPARTP4ENT SEPTIC TANK PERMIT
No of Bedrooms vZ Date LM v1 7-, l �, �, l
This permit is granted o r, for the installation of a septic tank
at the residence of 1`Nkc� �„-�-� Address
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal.
Manufacturer's Name Address
No of lines width in. Total Length ft. No. of Sq. Ft.
Type of filter material
Minimum Requirements: House Trailer
Two --bedroom houst
Three-bedroom house
Tank Cap.
Total tons used
800 Sq. ft. line
800
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 Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
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