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P102770 McDaniel
DAVIE COUNTY HEALTH DEPAR01ENT SEPTIC TANK PERMIT No of Bedrooms 3 Date /D --�} / %,Z) This permit is granter to for the installation of a septic tank at the residence of Address , Building Contractor Address Septic Tank Specifications: Length Width Depth Capacity Gal.` © o Manufacturer's Name ` ^ � No of lines width in. Total Address 42--/ Length ')ft. No. of Sq. Ft. Type of filter material Total tons used 7l Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400 Two --bedroom house 800 600 �I Three-bedroom house 900 900 No We 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 ins alled according t specifications. Signed:-�- eptic Tank Contractor Note: Make sketch of disposal system on back of sheet and mail to Health Center, Mocksville. ,, � __ .. -, ... .. ... r. - � �- ..: ._ _ _ .. -