602 Redland Rd (2)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms Date r,7, e /i6 5
This permit is granted to bon : for the installation of a septictanrk
at the residence of o rt Address 1, Qcrs �e sZ
Building Contractor yK Q-2- ��( — Address
Septic Tank Specifications: Length Width Depth Capacity Gal. 200
Manufacturer's Name 4-tdl Address ? �.
No of lines �r width n. Total.Length ft. No. of 6q. F .�/
Type of filter material Total tons used
Minimum Requirements: House Trailer Tanks 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.
Signed: . &_a__Y� ri, L
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.