P111269 Hwy 158 Patterson Trailer ParkDAVIE COUNTY HEALTH DEPART111ENT SEPTIC TANK PERMIT
?T- -, uti- Date //—/;z —6
This permit is granted t 6e aij for the installation of a septic tank
at the residence of Address
Building Contractor r,T,mss o h Address
Septic Tank Specifications: Length Width Depth Capacity Gal. 00
Manufacturer's Name Addressi<
No of lines width :L Total Length ft. No. of Sq. Ft.
Type of filter material Total tons used ,&"4,�r�e,
Minimum Requirements: House Trailer Tana. 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 ins alled accor 'ng to
specifications.
Signed: Aa -,a
Sept'c Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.