P7871 Leeper1
DAVIE COUNTY HEALTH DEPART11ENT SEPTIC TANK PERMIT
No of Bedrooms 7; lt° Date
This permit is granted to ` .7-, 0g� for the installat' o septic tank
at the residence of Address
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity �A Ga -l/. 5'a --b
Manufacturer's Name Address
No of lines_, width in. Total Length
ft. No. of Sq. Ft. �ec�
Type of filter material Total tons used
Minimum Requirements: House Trailer Tank Cap. 800. 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:G��`7
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.