P122971 Hwy 601S�L
DAVIE COUNTY HEALTH DEPART11ENT SEPTIC TANK PERMIT
No of Bedrooms � Date / — - V
This permit is granted to ^l�!�S for the installation of a septic tank
at the residence of '` Address �Y1
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal. 900
Manufacturer's Name c�-,; Address �3
No of lines�width J !oi . Total Length ft. No. of Sq. Ft.
Type of filter material Total tons used --- `5 1 2 0
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
Officer or his agent.
Date of final approval
County without a permit from the Health
Signed: _
Sanitarian
I hereby certify that the above septic tank has been installed according to
specifications. /
Signed: % r7'J e IL /�ezel—
Septic Co ractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.