370 Hwy 901W (2)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
of Bedrooms
-
Date.
izi5 permit- is granted to �%h
2, --Q for the installation of a septic
tank-.
:t the residence o
Address
Building Contractor '�tz u��, u ���
Address
Septic Tank Specifications: Length Width -__Depth_ Capacity __Gal,
Iv'.•:.nufacturer`s Namel�—a '-p �� �o�
Address 6-64_0 - "
ITe„ of lines 4 width in. Total Length _ft. iio. of Sq. Ft.
Type of filter material _-� �'
Total tons used
M.i.nimum Requirements: House Trailer
Tank Cap. 800 Sq. ft. line
400
600
Two-bedroom house
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 - - 6 i
Signed: _ i
Sanitarian
I hereby certify that the above septic tank has been installed according to specifications.
r
Signed:��Jl
Septic Tank Contractor
Note: Make sketbi.. of disposal system on back of sheet and mail to Health Center, Mocksville,
3Q