1889 Milling RdDAVIE COUNTY HEALTH DEPARVIENT SEPTIC TANK PERMIT
No of Bedrooms Date — 1 -2
This permit is granted o for the installation of�a septic tank
at the residence of o i ar res Address /�f�;�13�,� �� b z_ _
Building Contractor i _o if (51., Address p� "
Septic Tank Specifications: Length Width Depth Capacity Gal.
Manufacturer's Name Address
No of lines width in. Total Length ft. No. of Sq. Ft.
Type of filter material Total tons used
Minimum Requirements: House Trailer Tana Cap. 800 Sq. ft. line 400
Two-bedroom house 80 60
Three-bedroom house 900 00
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.
y aDSigned:
Septic Tank Contractor
`N`o`t: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
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