P81668 County Home RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
Lo., of Bedrooms 11,y5P -r qee__ Date
':his permit is grante to %14 �' F ��-,n(,c_ /�4�C� for the irstallat on of a s ptic tare .
at the residence of �, �, Address _
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal. _ b G
Manufacturer's Name r/A tJ� �1/ C �FY�� Address ,
No. of lines!/—widthin. Total Length ov ft. Lo. of Sq. Ft. (I a o
Type of filter materialTotal tons used C�
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
Tank Cap. 800 Sq. ft. line 400
800 600
900 900
County without a permit from the Health Officer
Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to specifications.
Signed:
Septic Tank Contractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksville-
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