2551 Hwy 601NDAVIE COUNTY HEALTH DEPARTPIENT SEPTIC TANK PERMIT
No of Bedrooms �` ��
Date
This permit is granted to S
- for the installation of a sep is tank
at the residence of
Address
Building Contractor
Address
Septic Tank Specifications: Length
Width Depth Capacity Gal. 9 ua
Manufacturer's Name s 9 IT., a - Address & T �
No of lines�r width__4 ein. Total
Length Zao ft. No. of Sq. Ft. a D
Type of filter material Z�Z D
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 beVinst lledaccording tospecifications.�Signe
Septic Tank Contractor
Note: Make sketch of disposal system
on back of sheet and mail to Health Center,
Mocksville.
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