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P41467 Spillman Rd
FA DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERTNIAIT of Bedrooms Date ".his rermit is granted to � � � �Q rft r� for the installat on of a septic tank _ .t the residence of _ Address Building Contractor�/`a�4 u L Address 1�r� a•�c� �> __ Sei,t;ic Tank Specifications: Length Width Depth_ Capacity Gal. s,'. A•:::aZuffacturer s Name Address No:. of lineswidth in. Tot 1 Length . ooft. No. ofYS'q. Ft. _ p hire of filter material Total tons used TTin aura Requirements: House T ailer Tank Cap. 800 Sq. ft. line 400 Two-bedroom house 800 60-0 Three-bedroom house 90090 No one shall install a septic tank in Davie County without a permit from the Health Offi r or his agent. ©� Date of final approval e'- i Signed: Sanitari.- I hereby r.ertify that the above septic tank has been installed according to specifications. Signed: 5�-�— Septic T Contractor Note: 'Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksville. T /O