P5770 FosterDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT '
No of Bedrooms Date
This permit is granted to for the installa ion s ptic tank
at the residence of Address / , Albcl s ,
Building Contractor Address `
Septic Tank Specifications: Length Width Depth Capacity Gal.
Manufacturer's Name Address
No of lines width in. Total Length ft. No. of Sq. Ft.
Type of filter material Total tons used
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line
_40-
Tvo-bedroom house 800 600
Three-bedroom house 900 900
No one shall install a septic tank
Officer or his agent.
Date of final approval
in Davie County without a permit from the Health
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.