P122171 HarpDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms ►^ or ; �° �'_
Date
This permit is granted to
for the installs ion of a
septic
tank
at the residence of
Address ,o? L (,ru
�C
Building Contractor
Address
Septic Tank Specifications: Length
Width Depth Capacity
Gal. 9
Manufacturer's NameAddress
1�z
c�
r
No of lines width in Total
Length eft. No. of Sq. Ft.
Type of filter material
Total tons used
Minimum Requirements: House Trailer
Tank Cap. 800 Sq. ft.
line
1+00
:Two-bedroom house- 800
600
ti
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 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.