479 Riverdale RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms %3
Date //I- % —
This permit is granted to
for the installation of a
septic tank
at the residence of f F r y CI_
Address
Building Contractor T jS22ve ���9�. t _
Address _ZF 7
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Septic Tank Specifications: Length Width
Depth
Capacity
Gal. �a
Manufacturer's Name 0,M.y
Address -.2-
5 aoc
K.s
No of lines_L width__in. Total Length
d5 ft. No. of Sq. Ft.
9 n
Type of filter material
Total
tons used
Minimum Requirements: House Trailer
Tank Cap. 600
Sq. ft.
line 400
Two --bedroom house-
800
600
Three-bedroom house
goo
goo
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.
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