203 Overlook Dr Lot 8DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
M;,) . of Bedrooms Date Jr�
This permit is granted to �
��rw.. , %, �� � for the ir_stal tion of aseptic tank -
at the residence of Address _
Building Contractor Address
Septic Tank Specifications: Length Width _Depth Capacity Gal.
Manufacturer's Name -� Address_
I?o. of lines width in. Total Length 3l x3%ft. .ro. of Sq. Ft.
Tyne of filter material Total tens used
Nin.imu:n Requirements: House Tr filer Tank Cap. 800 Sq. ft. line 40o
Two-bedroom house 800 600
Three-bedroom house900 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:
'5 f
( Septic Tank Contractor
3
Note g Make sket h of disposal system on back, of sheet and mail to Health Center, Mocksvili.e.