P82967 HarrisDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
of Bedrooms c% Date y g
:his permit is granted to for the installation of a septic tank..
at the residence of Address`
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal.
Manufacturer's Name c3di_2rr.�� Address
No. of lines width 3<. in. Total Length ft. Uo. of Sq. Ft.
aIype of filter material Total tons used
Minimum Requirements:
No one shall install a
or his agent.
Date of final approval
House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 800 600
Three-bedroom house 900 900
septic tank in Davie County without a permit from the Health Officer
Signed:
Sanitarian
1 hereby certify that the above septic tank has been installed according %t�o specifications.
Signed: d(_t_,tAT_,7e—TKY _
Septic Tank Contractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksville.
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