P22868 Davie Academy RdDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERiMIT �
jTo, of Bedrooms i2 Date
"'his permit is granted tov �ivy� ` for the installation of a septic tank.
;t the residence of Address
Building Contractor TEIK Address
Septic Tank Specifica/ions: ength Width Depth Capacity ,Goal. 4- ,j -D
Manufacturer's Name.- Address
Ho. of lines width in. Total,Lepgth ft. Uo. of Sq. Ft.
Ty -pe of filter material aTotal tons used _
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 800 �QO
Three-bedroom house 900 900
No one shall install a septic tank in Davie County without a permit from the Health Officer
or his anent.
Date of final approval v2-.2 Signed:
Sanitarian
;. hereby certify that the above septic tank has been ins lied accord'ng o specifications.
Signed: Aw�
Sepp-'& Tank Contractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksville,
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