222 Whitaker Rd (2)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms 3 Date Se -Q,
This permit is grantedt l� for the installation of a se tic tank
at the residence of Address
Building Contractor Address
Septic Tank Specifications: Length Width Depth,
Manufacturer's Name Address
Capacity Gal._
No of lines width in. Total Lengthft. No. of Sq. Ft.
Type of filter material Total tons used
Minimum Requirements: House Tra' er 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.
r
Signed:9_ze_��
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.