P72071 Daye LnDAVIE COUNTY HEALTH DEPARTTIENT SEPTIC TANK PERMIT
No of Bedroomr� a %. , ,rI Date % u /
This permit is'rgranted to for the installation of a eptic t
at the residence of Address, 4 nclaq r-
Building Contractor ; ` Address
Septic Tank Specifications: Length Width Depth Capacity Gal.
Manufacturer's Name Address
No of lines width in. Total Length ft. No. of Sq. Ft.
Type of filter material 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 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 Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
I
lu
DAVIE COUNTY HEALTH DEPARVIENT
SEPTIC TANK PERMIT
% lP,r.s
No of Bedrooms i` 4 ! e d y' �' �t
Date op V LC l
This permit is granted for the i sta lation of at�c t
at the residence of Y' Address ✓ c - Vo
Building Contractor Address
Septic Tank Specifications: Length Width
Depth Capacity Gal.
Manufacturer's Name
Address
No of lines width in. Total Length
ft. No. of Sq. Ft.
Type of filter material
Total tons used
Minimum Requirements: House Trailer Tank
Cap. 800 Sq. ft. line 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
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 Health Center,
Mocksville.