231 N Pino RdDAVIE COUNTY HEALTH DEPAR7IEUT SEPTIC TANK PERMIT
No of Bedrooms % ra%� r /emlaar�r Date�-
This permit is granted to for the installs ion of a pie -c ank
at the residence of EeJ1VZL&10 Address
Building Contractor Address,c��
Septic Tank Specifications: Length Width Depth Capacity Gal.
Manufacturer's Name Address r
No of lines 3 width 3 4 in. total Leng hos ft. No. of Sq. F .
Type of filter material S _ & Total tons used
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 1+00
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 ins
specifications. ,
Signed:
is Tank,/Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
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