P22569 TroutmanDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
of Bedrooms 6-21 Date c?�
':his permit is granted to for the installation of a septic tank_
at the residence of—�2d cru Address �h/,
Building Contractor Address 7' _
Septic Tank Specifications: Length Width Depth Capacity Gal.da
Manufacturer's Name Address,�-.
No. of lines width� 1A < in. Total Length �+ 5� ft. Pio. of Sq. F _ cS--
-:-hype of filter material s Total tons used �16(Q
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 4
Two-bedroom house; . ,,, 0�0� 60
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.
Sgned: '1104 ; (�� �-- _
Septic .Tank Contractor
Note: Make sketb*.t of disposal system on back of sheet and ma 1 to Health Center, Mocksville,
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