P112470 WebbDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms 4 c� Date 1 /- f 9 0
This permit is granted to for the installation of a septic tank
at the residence of Z rr Address _X/1
Building Contractor I I - Address
Septic Tank Specifications:. Length Width Depth Capacity Gal.E)
Manufacturer's Name !�,�.�0 !( Address IF
No of lines _,width�in. Total Length _,Loft. No. of Sq. Ft. 600
Type of filter material "`f Total tons used �? 3
Minimum Requirements: House Trailer 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:
Sanitarian
I hereby certify that the above septic tank has been installed according to
specifications.
Signed:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.