130 Lester Dr Lot 29DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms 13 Date / .- a �— 9,/This permit is granted to Rg5.46tt f l/;S for the installation of a septic tank
at the residence of Address
Building Contractor C iH Zrn Address r ' q c
Septic Tank Specifications: Length Width Depth Capacity Gal.. 0 v
Manufacturer's Name - _ Address 3 \_
No of lines 3 width_,U S. Total Length 300 ft. No. of Sq. Ft: ;�00
Type of filter material ,442E a Total tons used 63/, },S—
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.
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Signed:' t �?✓ f �.
Septic Tank Contract6r'
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
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