1490 County Line RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
To of Bedrooms
Date
i
.anis permit is grante to � �+� for theinstallation of aseptic tan's..
at the residence of —.-Address .4-7e
Building Contractor Address
Septic T,=k Specifications: Length Width Depth` Capacity Gal. 2o 0
7 c
Manufacturer's Name61L f 9' 71A, Address/0
No,, of lines�_width�in. Total Length w�� ft. No. of Sq. Ft. ( 0,0
ly e of filter material Total tons used
P,linimmn Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 800 60G
Three-bedroom house 900 900
No one shall install a septic tank in Davie County without a permit from the Health Officer
or Lis agent.
Date of final approval Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to specifications.
Signed: a b �r _ p _
Septic Tank Contractor
Note: Make sketbi: of disposal system on back of sheet and mail to Health Center, Mocksvilley
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