187 Turrentine Church RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms 3 Date —3 d
This permit is granted_±,o__n J',--- 02c, -r- for the installation of a se tic tank
at the residence of r• r 5. Co u c Address
Building Contractor Address %% ,/y,,'
Septic Tank Specifications Length Width Depth Capacity Gal. D 0
Manufacturer's Name (f Address
No of lines_ width in. Total Length aasft. No. of Sq. Ft. 9,00
Type of filter material Total tons used
Minimum Requirements: House Trail 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 installed according to
specifications.
Signed: L'C
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.