P121068 BeckDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
`llo, of Bedrooms Date
This permit is granted to for the installation of a septic tank.
at -the residence of S , 2C Address
Building Contractor jf4�lv,.�,� ` Addressf,
Septic Tank Specifications: Length Wi Depth Capa4ty Gal. 261b�
Manufacturer's Name _ ,►tea-aa✓� Address e�
Ido. of lines__width ' in. Total Length I �"D ft. Pio. of Sq. Ft"�
Type of filter material v 4. Total tons used / �__ +
Minimum Requirements: House Trail r 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: y
Sanitarian
I hereby certify that the above septic tank has been installed according to specifications.
Signed:C/-/�{
Septic Tank Contractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksville,