P82768 Bootleg AlleyDAVIE COUNTY HEALTH
DEPARTMENT SEPTIC TANK PERMIT ,
o, of Bedrooms o?
Date
his permit is granted to
for the ir_stal al tiop/of a septic tank,.
at the residence of ZI; tr t >t �'
Address
Bu.lding Contractor
Address
/
Septic Tank Specifications: Length
Width Depth
Capacity Gal. 900
�,1c nufacturer ° s Name
Address
_
Ito, of lines widthZ,("I in. Total
Length _�ft. No.
of Sq. Ft.
` -jpe of filter/ material �.'7c Wit.
�� Total tons
used o?n _ Tw
-j4/0
1�14 ni;aum Requirements: House Trailers
Tank Cap. 800
Sq. ft. line 400
Two-bedroom house
800
500
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.
:Gate of final approval
Signed:
Sanitarian
hereby certify that the above septic tank has been instal 'd according to s ifications.
Signed:
Septic Tank Contractor
Note: Make skete: of disposal system on back of sheet and mail to Health Center, Mocksville.
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