449 Hillcrest Dr' l � .. .._ _�. ... .. _ 4 .�.... ..-- _._._._ .... _.. .... ... ..
DAVIE COUNTY HEALTH DEPARTPIENT SEPTIC TANK PERMIT
No of Bedrooms Lo p -r— Date ;�r % ) % O
This permit is granted to 0'4lVz,, for the installation of a septic tank
at the residence of LQ-M<Pr P, h/0 /I/ Address �--T=
Building Contractor QV2 Z47, -c, , Address
Septic Tank Specifications: Length Width Depth Capacity �Q Gal. Y6 b
Manufacturer's Name Address 7` j9,�--
No of lines cat width �� in. Total Length oa ft. No. of Sq. Ft. �o[�
Type of filter material ro Total tons used o70 -A
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two --bedroom house 800 6
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.
Septic Tank Con
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.