701 Duke Whittaker RdDAVIE COUNTY HEALTH DEPARVIENT SEPTIC TANK PERMIT
_
No of Bedrooms �1/7Ni � -,—Date �/— /% —
This permit is granted to 4u ,c a x t,S for the installation of a septic tank
at the residence ofkrq�®n F%. 4edr, ddress RaIx IK Y r
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal. 9 oPp
Manufacturer's Name Address 4
No of lines_ width in. Total Length ft. No. of Sq. Ft.cfU
Type of filter material Total tons used o
Minimum Requirements: House Trailer 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
I hereby certify that the above septic tank has been installed according to
specifications.
Signed: Oz_-��
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.