P111971 Deadmon Rd #2A
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms �3
Date
/f—
This permit is granted
_ _
to 7-1 e , for the installation of a septic
tank
at the residence of
Address
Building Contractor
` Address(
0,/v. C •
Gal. 190
Septic Tank Specifications. Length Width Depth Capacit-y�/
Manufacturer's Name
Address
'
No of lines_ width
in. Total Length ft. No. of
Sq. Ft.
Type of filter material Total tons
used
Minimum Requirements:
House Trailer Tank Cap. 800
Sq. ft. line
400
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.
Signed:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.