P4370 HutchinsDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms Date
This permit is granted to for the installation of a septic tank
at the resiknce of Address
Building Gon Address `�n,cuxx-r
Septic Tank Specifications: Length Width Depth Capacity Gal. 7,-o
Manufacturer's Name ' / Address
No of lines width Total Length _...qo ft. No. of q. F ...S -4c
Type of filter material Lc � _ Total tons used 12
-
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 certifyNthat the above
specifications.
Note: Make sketch of disposal
Mocksville.
septic tank hasNbeen installed according to
Signed: f Lo_Y_
Se is Tank Cc9ractor
system on back of sheet and mail to Health Center,
Ir-t-r 0