P123071 Vogler RdDAVIE COUNTY HEALTH DEPARTIMET SEPTIC TANK PERMIT
No of Bedrooms 07 Date /a —J This permit is grantedto for the ins allation of a septic tank
at the residence of 4, TO s 7= qeg Address /, /,,1ug n c e-
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity p Gal. D o
Manufacturer's Name Address
No of lines_ width( iii. Total Length �ft. No. of Sq. Ftp tel=
Type of filter material Total
Minimum Requirements: House Trailer Tank Cap. 800
Two --bedroom house 800
Three-bedroom house 900
tons used
Sq. ft. line 1+00
600
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.
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