P2867 Milling RdDAVIE COUNTY HEALTH DEPARTDIENT SEPTIC TANK PERMIT
io, of Bedrooms _ Date ,2 -- L
fi'his permit is granted to .%� �� e" for the installation ff a tank -
at
tan
at the residence of ���� �F (,� , Address <��l',�<X�61
.
.Dui�dinG Contractor Address
Serotic. Tank Specifications: Length Width Depth Capacity Gal.
Manufacturer's Name Address
llo,, of lines (:,<, widthin. Total Length;5 (� ft. '.'o. of Sq. Ft.
Type of filter material .'��1—ctic� ---—� Total tons used _
i�ii.nizntun Requirements • House Trailer I Tank Cap Sq. ft. line 00
i;,)—
Two-bedroom house 800 60o
Three-bedroom house 00 900
No one shall install a septic tank in Davie County withou a permit from the Health Officer
or r4 '
4. s agent.
Rita of final approval Signed:
,/ Sanitarian
I hereby certify that the above septic tank has been installed according tospecifications.
Signed:_�::,'4���C��_-
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center, Mocksville.