P71169 Hwy 64WDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
11o, of Bedrooms
Date
This permit is granted to
for the installation of a septic tar.;;
at the residence of
Address
Building Contractor rR
Address
Septic Tank Specifieatic s: Length Width
Depth Capacity 6fGri. g in
Manufacturer's Name
Address a� ll i C �
Ft
Ido; of lines Total Length -1.7
i ft. Elo. of Sq. ?'D O
_L
Typo of filter material El-
Total tons used /o7C
44nimiun Requirements: House Trailer Tank
Cap. 800 Sq. ft. line I+00
Two-bedroom house
800 6c0
Three-bedroom house
900 900
No one shall install a septic tank in Davie County
without a permit from the Health Officer
oy his agent.
Date of final approval
Signed. _
Sanitarian
I hereby certify that the above septic tank has been installed according to specifications.
Signed: K44
✓ S tic Tank Contractor
Note: Make sketb� of disposal system on back of sheet and ma' to Health Center, Mocksville..
O
'Y