P22571 Woodward RdDAVIE COUNTY HEALTH DEPART114ENT SEPTIC TANK PERMIT
No of Bedrooms 3 Date a 5 �
This permit is granted to_b �: c' c % i��l� for the insta lation of a septic tank
at the residence of ' Address 14,-OIwar-d
Building Contractor Ao ✓ / qXW/ S Address /Y! oC
Septic Tank Specifications: Lengtho Width_r- Depth Capacity Gal.
Manufacturer's Name-b,R� / ,c ) A„/4 Address
No of lines_(_ width in. Total Length s ft. No. of Sq. Ft. (goo
Type of filter material j % on/ F Total tons used 3 �-
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:
eptic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.