1927 Farmington Rd (2)DAVIE COUNTY HEALTH DEPARTPIENT SEPTIC TANK PERMIT
No of Bedrooms Date
This permit is granted to ,Cdu i,,,,7 t�f o�+►*soK Jr -for the installation of a septic tank
at the residence of F• ;tv�K ��._ J'r• Address P,6 a c 'J'W"
,c' .
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 Total tons used
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:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.