P110370 Hwy 801SDAVIE COUNTY HEALTH DEPARTr4ENT SEPTIC TANK PERMIT
No of Bedrooms 3 � Date r/— '? -- i O
This permit is granted to AWa,, E .'s for the installation of a septic tank
at the residence of Addressc�i/a h c�
Building Contractor Address
Septic Tank Specification//s:-.Length Width Depth Capacity Gal.
Manufacturer's Name ��1�4� Address�3
No of lines_ vridth„2� in. Total Length �ft. No. oSq./Ft./ 2 o 0
Type of filter materialTotal tons used 30,
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 1+00
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. y
Signed: �-
Septic Ta Con actor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
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