P62270 Davie GardensDAVIE COUNTY HEALTH DEPARMENT SEPTIC TANK PERMIT
No of Bedrooms_ Date 4-2-2-17b
This permit is granted -to - for the installation of a septic tank
at the.residence of ddressvc�_�4 _
Building Contractor. Address )f
Septic Tank Specifications: Lengt _ Width Deptk Capacity Gal. 96,6
Manufacturer'.s Name Addressi
No of lines—�?,_'width in. Total Length oo ft. • No. of Sq. it./ Ir -a'
Type of filter material to i Total tons'used -7A
Minimum Requirements. House Traile Tank Cap. 800 Sq. ft. line 400
Two-bedroom Lse 800 600
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.
Date of final approval i Signed: _
Sanitarian
I hereby certify that the abode septic tank has been installed according to
specifications.
Signed:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and. mail to Health Center, 1
Mocksville.
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