P11868 Hwy 601NDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT �J
T: o, of Bedrooms _7 Date
':his permit is granted to 74✓� /��/ ��7, �� for the installation o a septic tank -
at the residence ofa.��u h�or!�6'1Z Address l
Building Contractor `C-� �, )�Vc-/,r Wr iC Address
Sept>,c Tank Specifications: Length Width Depth Capacity Gal. ao _
Manufacturer's Name Address
No. of lines / width 7-6 in. Total Length 62aS�ft. Uo. of Sq. Ft.
Type of filter material Flo Total tons used `Z
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
or his agent.
Date of final approval
County without a permit from the Health Officer
Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to specifications.
YS � Signed: � �7
Sd'tic Tank Contractor
Note: Make sket h of disposal system on back of sheet and mail to Health Center, Mocksville.
/0:�
qs��L�
------------------