118-124 Calahaln RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
Uo. of Bedrooms �J Date /2- - z G
This permit is granted to '!ua- � (_ _�_ �,_ for the installation of a septic tank-.
at the residence of Address
Building Contractor Address /f ' / }�LAc!'d +�1:�.^� �Si C
Septic Tank Specific ions: Length Width Depth Capacity Gala
Manufacturer's Name Address_
No. of lines width i . Total Length _ ft. Yo. of Sq. Ft.
Type of filter material
Total tons used
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 60Q
'Thr ee bedroom house ��� 90 00
No one shall install a septic tank in Davie County without a permit from the Health Officer
or his agent.
Date of final approval % 2 - 2 Signed: f 9. .6 coca__
Sanitarian
T hereby certify that the above septic tank has been installed according t specifications.
Signed:
Septic Tank Contractor
Note: Make sket'-, of disposal system on back of sheet and mail to Health Center, Mocksville,