753 Turkeyfoot Rdd 5,X fo o
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms Date —.
apg e OZ,
This permit is granted to t C°r for the installation of eptic tank
at the residence of mac[ % o u 7�rn c n Address/'
Building Contractor C9:4M&- Address
Septic Tank Specifications: Length Width Depth Capacity Gal.1ff-jz
Manufacturer's Name �i,�.�,6Z Address
No of lines width 40PIL
Total Length _ Y�"ft. No. of Sq. Ft. _ 9 a C2
Type of filter material _— a o N p Total tons used 2M---
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
Officer or his agent.
a septic tank in Davie County without a permit from the Health
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.