140 Whitaker Rd (2)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms LIZr
Date
(Q —� —
� 0
This permit is grant '/ wt
for the installation of a
septic
tank
at the residence of
L
Address
Building Contracto __�_
Address
Septic Tank Specifications: Length
Width Depth Capacity
Gal. 6g
r
Manufacturer's Name
Address
3
No of lines_ widti�(inO Total
Length ft. No. of
dq. Ft.
Type of filter material
Total tons
used
Minimum Requirements: Hous" Trailer
Tank Cap. 800
Sq. ft.
line
1+00
Tvo-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 in talle according�t�
specifications.
Sign
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.