2551 Hwy 601N (2)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
i3O' of Bedrooms Z rra c` /e r' Date
his permit is granted to r 1 ti _ N,1G �c for the installation of a septic to k
at the residence of . /7 4je //--. //� Ks ��' r Address
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal. D o
,aiufaeturer's Name Address
No., of lines l width S-' in. Total Length 1-,>,o ft. Uo. of Sq. Ft. 5'at!.
Type of filter material Total tons used
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 1+00
Two-bedroom house 800 600
Three-bedroom house 900 900
No one shall install a
or his agent.
Date of final approval
septic tank in Davie County without a permit from the Health Officer
Signed:
Sanitarian
I hereby certify that the above septic tank has been instai ed according to s cifications.
Signed: �/2
Septic Tank Contractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksville,