P7771 WadeDAVIE COUNTY HEALTH
No of Bedrooms =r.x
;This permit is granted to
at the residence of ,��►�• /Atm
F.PARTP SEPTIC TANK PERMIT
Building Contractor
Septic Tank Specifications: Length W -
Date
fo t e installatibApgA septic tank
A dr ss 07, 471
es
Depth Capacity Gal.
Manufacturer's Name Address
No of lines width in. Total Lene h ft.` No. of Sq. Ft.
'o of filter material _ Total tons used
Minimug,Requirements: House railer T nk Cap. 800 Sq. ft. line,..
Two_be room house 800 �� y �. 600
Three edrS2 us 90 ���._ -. .'' ` 900
No one shall install a septic- tapk in vie County --without a p--"e� t 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
s ecifications.
Signed:_
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.