P2172 DraughnDAVIE COUNTY HEALTH DEPART11ENT SEPTIC TANK PERMIT
No of Bedrooms
Date
_ J
This permit is granted to;,, ;j (_a. for the installation of a
septic
tank
at the residence of�rr%�rn._ Address
Building Contractor;'.)Address
Septic Tank Specifications: Length Wit
Depth Capacity
Gal.
Manufacturer's Name ' ',u_l
Address
No of lines__ width V-(-Iin. Total Length �
2) ft . No. of Sq. Ft.
Type of filter material z�-,( a �.�Z:'
Total tons used
3
Minimum Requirements: House Trailer Tank
Cap. 800 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 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:`
1
eptic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.