397 Greenhill Rd (2)D�AVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
'o., of Bedrooms. Date 1-- -o-
'nhis permit is granted to for the installation of a septic tank_
at the residence of Address
Bui;ding Contractor Address
Septic Tank Specifications: ength Width Depth Capacity&o _.Gal.
Manufacturer's Name L. Address
No. of lines width_ in. Total Length ft. Pio. of Sq. Ft. z i _
i
Type of filter material 1� '-�� Total tons used 2
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 1+00
Two-bedroom house 800 500
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 tg specifications.
Signed:
Sept c Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center, Mocksville.
Al