P31372 ScottIT
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91
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms -3 Date & /,? - 9 -7 --
This
L_This permit is granted o O� for the installation of a septic tank
at the residence of Address / j I % , /?7'.- :4 o r Coo let -mg -e
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal. y oa
Manufacturer's Name9952�u�Address 1AF 7/��
No of lines_ width _ in Total Length ,JoSft. No. of Sq. A. 4-13-X / v
Type of filter material ;:�!- i n Total tons used SZ
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:
I hereby certify that the above septic tank has been `installed ac
specifications. %% , /
Signed:
Note: Make sketch of disposal system on back of
Mocksville.
Sanitarian
th Center,