P63071 Leeper1llirs f�, 4,, t/e hd l y< f f r- o G
DAVIE COUNTY HEALTH DEPARrHENT SEPTIC TANK PERMIT
1 •
No of Bedrooms Date 3 4
This permit is grante to for the ins` latio f aseptic tarik
at the residence of T, Address e t72
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. Sq. ft. line 1+00
Two --bedroom house- 800 600
Three-bedroom house 900 900
No one shall install a septic tank in Davie County without
Officer or his agent.
Date of final approval
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.
o
erg r/ ~ c.1 r
DAVIE COUNTY HEALTH DEPARTIMENT SEPTIC TANK PERMIT
D
No of Bedrooms /7J- _ \ '
Dat
This permit is grante to, for the insta la iio ,of a se tic tank
at the residence of ;- ��1 t s2�. �. Address ?fir �� cY Y-'' P
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 To � tons used
Minimum Requirements: House Trailer Tank Cap.. Q0J Sq. ft. line
Two --bedroom house- 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:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.