Cecil MorrisDAVIE COUNTY H'IALTH DEPAR71MT
SEPTIC TANK PEM.1IT
No. of Dedrooms 2- Date Jce,� ,3 — /4/
This permit is granted to_ -¢for the installation of
a Septic Tank at the residence of ��✓-��rT�l�, Address
Duilding Contractor
Septic Tank Specifications: Length Ti"Width ,-,?'f Depth �. Capacity t7,0 0 Gal,
Manufacturerts Name Address
No. of lines�_11idth 3 in. Total length 2 0 0 Ft. No. of Sq. Pt, v o
Type of filter material _r Total tons used 2—o
Minim= Requirements: Tank Capacity Square Ft. of bine
House Trailer 800 100
Two -Bedroom House 800 600
Three-Dedroom 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 the
Health Center in Mocksville.