P81171 Foot - BooetownDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms N ,,`/.,� Date %% 7L74
This permit is g ante to for the installation cX a septic ank
at the residence of oa Address epyp_be-)K ._ r, -/r< -e
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal.
Manufacturer's Name Address��
No of lines width in Total Length _416--f-t. No. of Sq. t. OSS'
Type of filter material Total tons used
Minimum Requirements: House Trail Tank Cap. 800 Sq. ft. line 400
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:
`tt SepTa
ti nk Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
�� ::�" � .
r.,.._ ... _...,. _. _ ..... ..... . -... ._._... __...._ _ ..._ _ __ ......__. _ ........
.,