385 Ben AndersonDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms --3 R Date
This permit is granted to i -to ,` YI�G' for the in allation of a rse tic tank
at the residence of A Address•
Building Contractor v� LC%Z �' Address
Septic Tank Specifications: Length Width Depth Capacity- Gal.
Manufacturer's Name --<11 Address T, 9 C�y.
No of lines / widths ' Total Length .2 -15 --ft. No. of 6q. Ft:
Type of filter material 10 o Total tons used
6VS- 4 -
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 800 600
Three-bedroom house 900 904
No one shall install a septic
Officer or his agent.
Date of final approval
tank in Davie County without a permit from the Health
Signed: _
Sanitarian
I hereby certify that the above septic tank has been installed accorAling to
specifications. j, w. on s �
Signed:
Se c Tank C tractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.