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P5667 Baltimore Rd
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT j of Bedrooms Date <6 !:his permit is granted to �"� {/, �d• for the installation of a septic tank-.. at the residence of _ Address Building Contractor Address Septic Tank Specifications: Le gth Width Depth Capacity Gal. 9 D(01 Manufacturer's Name .ti+_11 Address Ido of lines o2 width.3�. Total Length ft. ro. of q. Ft. 5 ao Type of filter material ,>c,c�rn<� � ,.n Total tons used YC) Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400 Two-bedroom house 800 600 Three-bedroom houseP 900� 900 No one shall install a septic tank in Davie County wit oh ut a permit from the Health Officer or his agent. Date of final approval Signed: ,j Sanitaria.. I b.ereby certify that the above septic tank has been installed according to specifications. Signed: �I�tl.-,---2 �- _. Septic Tank Contractor Note: Make sketc-. of disposal system on back of sheet and mail to Health Center, Mocksville. S7 I S ©�6,4'" V WOO =� CQ