P61170 Hwy 801S (2)DAVIE COUNTY HEALTH DEPART111ENT
SEPTIC TANK PERMIT
No of Bedrooms ( (`Q i �- Date
This permit is granted tofor the installation of a septic tank
at the residence of Address
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal. 900
Manufacturer's Name �Gtaa Address -13 `
No of lines_ width_.3,Qin. Total Length1 Ift. No. of 6q. F . ;'fid
Type of filter material -7,2`l0 Total tons used
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
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: Qzll.�
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.