P101971 Hwy 601SDAVIE COUNTY HEALTH DEPARV-1ENT SEPTIC TANK PERMIT
No of Bedrooms 9 Date A 4
This permit is grantedto for the installation o a sep?£ic tank
at the residence of Address
r
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal. 90-7D
Manufacturer's Name ` , i Address��f�
No of lines_ width_ in. Total Length f�ft. No. of Sq. Ft. S
Type of filter material 4!;t JD 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: 256W 552&
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.