149 Branchview Ln (2)�v NC.�.J
DAVIE CGTy T DEPAR01ENT
�a�*,yAt
1101,10
SEPTIC TANK PERMIT
No of Bedrooms 3 Date 191,
This permit is grant94. to for the installati6K of septic i
at the residence of 7"t O E� Address �.� p c-ky l
Building ContractoxsC�N1,c4�Address f7o? /v
Septic Tank SpecificatioiA: Length Width Depth -' Capa6it/ Gal.
Manufacturer's Name Address
No of lines width in. Total Length ft. No. of Sq. Ft.
Type of filter material o Total tons used
Minimum Requirements: House Trai er Tank Cap. 800 Sq. ft. line 1+00
Two-bedroom house- 800 600
Three-bedroom house MOM 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. / r
Signed:
S TnkC t t
ep c on rac or
0.
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
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