P32668 CartnerDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
of Bedrooms %2iE
Date"his per:,nit is grant��'f� for the irstallation ofa septic tank_.at t're residence of � _ Address ,
_ .. _ -._
Bui'i.ding Contractor Address -
Septic Tank Specifications: Length Width Depth Capacity Gal..
Ma ufact;urer's Name y Address
[To: of lines width ^in. Total Length _ ft. ,o. of Sq. Ft.
Tj .)? of filter material D !; gnu Total tons used _X -
"l. itwq
X-"s..i..nl.mrun Reqs irements • House Traile / Tank Cap. 800 Sq. ft. line 4:00
• Two—bedroom house 800 600
Three—bedroom house 900 900
NT
o one shall install a septic tank in Davie County Twithout a permit from the Health Officer
ox his agent„
Da"c of i.'ina?_ approval T_ Signed:
Sanitarian
z hereby c :rtf_fy that the above septic tank has been i.ns fled accordiro to_ specificatiens .
//S.3
Septi i'ank Co^tractor
Note: Dake sket `. of disposal system on back of sheet and mail to Health Center, Mocksville,
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