4395 Hwy 64W (4)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of=Redreew 06ei'l/[e-P �7� 6611A �- Qs� - om Date ?
2' --2
This permit is granted to for the installation of a septic tank
at the of S'5s0 0,, f fir, _ Address .w o
Building Contractor ` `D Address o r f -
Septic Tank Specifi-at ns: Length Width Depth Capacity Gal. oQ
Manufacturer's Name p Q 4� AddressP/, 3,—
No of lines %_3 width �t in. Total Length ODft . No. of Sq. Fd. Ilaco
Type of filter material Total tons used 6 O
Minimum Requirements: House Trailldr Tani Cap. 800 Sq. ft. line 400
1.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 beenins ailed accor ing
315"z' specifications. j
3D
oa Signed:
Septic Ta Contrac or
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
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