P111766 HodgeDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
'Io, of Bedrooms _ Fate
.his permit is granted to ��c`y �, J for the installation off a septic tail-_
at the residence of Address
Building Contractor �,� c pe,„Address
Septic Tank Specifications: LengthWidth Depth Capacity Gal. 9,M
c D
Manufacturer's Name Z�a"�-_9'7-1 6o Address
No. of lines -7 width�'e in. Total Length 5 ft. No, of Sq. Ft. )1D Q
Type of filter material Total tons used
MJJ..nimum Requirements: House Trailer Tank Cap. 800 Sq.
Two-bedroom _house 800
Three-bedroom house-
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No one shall install a septic an in ie County vithou a permit
or his agent.
Date of final approval Signed:
ft. line 4o0
boo
goo
from the Health Officer
Sanitarian
I hereby certify that the above septic tank has been insta led according to specifications.
Signed:
Septic Tank Contractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksville„
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