P4171 Milling RdDAVIE COUNTY HEALTH DEPARVMNT SEPTIC TANK PERMIT
No of Bedrooms � Date % 7/
This permit is granted to aZ4Y the Inst llation of a septic tank
at the residence ofAddress 3 �,
Building Contractor a.A-e,�Address
Septic Tank Specifications Length Width Depth Capacity Gal.
Manufacturer's Name Address
No of lines_ width �f� in. otal Length aj,,ft. No. of Sq. Ft. 9 cr-p
Type of filter material ��lr�„�sZ_ Total tons used 3Q
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Tvo-bedroom house- 800
Three-bedroom house 90 90a
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.
Signed:
Septic T Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.