1438 Hwy 801NDA`JIE COUNTY HEALTH DEPARn1ENT SEPTIC TANK PERMIT
No of Bedrooms 3 Date /-0—/7-67
This permit is granted to/-qq Is ,d L//:� for the installation of a septic tank
at the residence of ) Address j,L
Building Contractor _ Z .o h e Llbs Address
Septic Tank Specifications: Length , Width Depth Capacity Gal. 900
Manufacturer's Name Address__
No of lines ,; width 4in. Total Length ft. No. of Sq Ft,.
Type of filter material �% Q c7,zj;j 2, � n Total tons used 3/
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
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:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.