261 Scenic Dr (2)DAVIE.COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms � Date 20
This permit is grante to for the ins a latio f a deptic tank
at the residence ofvie- y- Address
rr
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal. zrz
Manufacturer's Name d% / Address
No of linesI width i.n. Total Length /oa ft. No. of S . Ft. Odb
Type of filter material _ Total tons used z
Minimum Requirements: House Trailer ,Tank Cap. 800 Sq. ft. line 400
Two --bedroom house 800 00
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
q
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.