607 Ijames Church RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
?, of Bedrooms Zi�- 9- a ,1RDate .5-- '-6
Thi' permit is granted to , for the installation of a septic tank_
.:.t the residence of _ /� �c,�lc Address
Dui'dirg Contractor Address
Septic Tank Specifications: Length Width Depth Capacity _Gal.
;';anufacturer's Name Address 4)< .
Ito. of lines width 3l in. Total Length r� ft. iio. of Sq. Ft. 0
Ty-
pe of filter material v -v— Total tons used
Minimum Requirements: House Trai er Tank Cap. 800 Sq. ft. line k0;
Two-bedroom house 800 60G
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
T hereby certify that the above septic tank has been installed according to specifications.
Signed: 0,2,AA-4-J1— 9
.- QfL s
7--- 1
eptic TanContractor
:dote: Make sket h of disposal system on back of sheet and mail to Health Center, Mocksville.
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