Major BeauchampDAVIE COUNTY HZALTH DEP0711ENT
SEPTIC TANK PIM -11T
No.
of Dedrooms
Date
This
permit is granted to
_Jthe installation
of
a Septic Tank at the residence of dress
Building Contractor Address
Septic Tank Specifications: Length 2�LjlidthE2�^Depth Capacity 26 D G R
Manufacturer's Name Address'] ,w_
No, of lines Width in. Total length D Ft. No. of Sq. Ft. D 0
Type of filter material Total tons usedi��
ldinir= Requirements: Tank Capacity Square Ft. of Line
House Trailer 800 400
Two -Bedroom House 800 600
Three -Bedroom House 900 900
No one shall install a septic tank in Davie County vrithout 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 `
Septi6 Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to the
Health Center in Mocksville,