1044 Yadkin Valley RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
'io, of Bedrooms Date j- Z 6 - 6
:':his permit is granted
to
for the installation of a septic tank_
3t the residence of l..J Address
Building Contractor Address
Septic Tank Specification Length Width Depth Capacity Gal. " c32i
Manufacturer's Name. -- Address
Ile., of lines width en. Total Length ft. Uo. of Sq. Ft. 0 0
Type of filter material
Minimum Requirements: House Trailer
Two-bedroom house
Three-bedroom house
No one shall install a septic tank in Davie
or his agent.
Date of final approval
Total tons used o? 0
Tank Cap. 800 Sq.
Agoo
County without a permit
Signed:
ft. line 400
Csoo
goo
from the Health Officer
Sanitarian
1 hereby certify that the above septic tank has been installed according to specifications.
Signed:
eptic Tank Contractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksville.