P102770 KellerDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms '? Date /,0 v2, 9 — 9 D
This permit is granted to� ) 6&4��Ifor the installation f a se tic tank
�
at the residence of 7„n e / �r Address �, _
Building Contractor Address
Septic Tank Specificcattiions:. , Length Width Depth Capacity Gal. 19
Manufacturer's Name 6 Address
No of lines_ width in. Total Lengthft: No. of Sq. Ft. i r�
Type of filter material , Total tons used
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 1+00
Two-bedroom house 800 600
Three-bedroom house 900 900
No one shall install a septic tank in Davie
Officer or his agent.
Date of final approval
County without a permit from the Health
Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to
specifications.
Signed:! Z - ---s
Septic T Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.