P62171 Davie GardensDAVIE COUNTY HEALTH DEPARTIMENT SEPTIC TANK PERMIT
No of Bedrooms Date
This permit is granted to a, "_ l`s for the i tal on of a septic tank
at the residence of rr r Address . Q
Building Contractor��aitions:
A Address
Septic Tank Speci gth Width Depth Capacity Gal.® 0
�?�,
Manufacturer's Name Address
s 1---`�•—
No of linep2 width i . Total Length D O ft. No. of Sq. 9,00
Type of filter material Total tons used 300".5
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line x+00
Two --bedroom house 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 Signed: _
Sanitarian
I hereby certify that the above septic tank has been installed according to
specifications. e��
Signed: �/
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.