P4271 BeauchampDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms Date -e7l — 7 /
This permit is granted tothe installation of a septic tank
at the residence of,9 < L�� L� Address _ .
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal._
Manufacturer's Name Address
No of lines_ widthi�, in. otal Length 2u c> ft. - No. of Sq. Ft.
Type of filter material �{�,_/���� Total tons used �>
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house. cg�r_? 60
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 Z— % l Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to
specifications.
Signed: z
Septic Tank Cpfitractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.