P9870DAVIE COUNTY HEALTH DEPARTPIENT SEPTIC TANK/PERMIT
r,
No of Bedrooms 'J Date
This permit is granted to . % for the installation Af a s ptic tank
at the residence of Address
Building Contractor Address
Septic Tank Specifications: Length Width Depth C�apa)city Gal.o�Soo
Manufacturer's Name` ^ 2 Address
No of lines_ width A. Total Length =ft. eft. No. of Sq. Ft. b O 2 --
Type of filter material Total tons used
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house. 800 600
Three-bedroom house 900 900
f-�r /006 l -2-0O
No one shall install a septic tank in Davie County without a permit from the Health
Officer or his agent.
Date of final approval 9 9 O Signed: c
anitarian
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.