425 Redland Rd (2)DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
i o, of Bedrooms Date
Phis pe.-mit is granted to � /%' .. for the installation of a septic tank_
it the residence of La ��� 1 c czc� Address a7, /I
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal. 90 0
Manufacturer's Name Address
;10, of lines width 31,E in. Total Length Dd ft. No. of Sq. Ft. 600
Type of filter material i_ Total tons used
idinimum Requirements: House Tr ler Tank Cap. 80 Sq. ft. line 400
Two-bedroom house xGO
Three-bedroom house 00 900
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: c
' Sanitarian
1 hereby certify that the above septic tank has been installed according to specifications.
Signed:
Septic Tank Contractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksville,
C7�r PNo�a9 s�1Qo1 �