P82863 Hwy 801SDAVIE COUNTY HLALTH DEPAR711ENT
SEPTIC TANK PER1.1IT
No. of Bedrooms Date' = 6 -
This permit is granted toJ. ��.� for he installation of
a Septic Tank at the residence of ess
Building Contractor Address
Septic Tank Specifications: Length Vidth Depth Capacity Gal.
Manufacturers s Name Address
No. of lines Width in. Total length Ft. No. of Sq.Ft.
Type of filter material� Total tons used &,,j 7,
Mi.nirnum Requirements: Tank Capacity Square Ft. of Line
House Trailer 800 400
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 G 3 Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according
to specifications.
Signed,
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to the
Health Center in Mocksville.