243 Grannaman DrDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms �Ir R 4 r— Date lo -lo -6
This permit is grantedyto CA,2,/A:2 _ or the installation f a, es' tic tank
at the residence of rsu Addre .y4L. M
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal. S'a o
Manufacturer's Name _. _.._ Address /
No of lines_ width 3 6 j9. Total LengthAf0— rqf. No. of q. Ft' s O
Type of filter material Total tons used If
Minimum Requirements: House TraileW 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 accor 'na to
specifications.
Signed: ., "!
SepticTank- Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.