P2271 AdvanceDAVIE COUNTY HEALTH DEPARUMNT SEPTIC TANK PERMIT
No of Bedrooms ? ✓ ), Date
This permit is granted to ".-.--CL- for the installation of ad eptic tank
at the residence of Address
Building Contractor �4ns�,r-�.e.✓�ddressi
Septic Tank Specifications: Length- Width Depth Capacity Gal. 2 $-1)e-)
Manufacturer's Name r Address
No of lines + widthsTonal i Length : g r
c�,ft. No. of Sq. Ft.
Type of filter material �__ ;;-max_ Total tons used
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 100
Two-bedroom hous 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 certify that the above septic tank has been installed according to
specifications.
Signed:.
u
Septic T Contrac or
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.