P40168 Howardtown Circle DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT rr l
%/►-a 1�G'az Date !Z- 1 -4
`"his permit is granted to for the installation of a septic tank...
at the residence of jr,6 o n Address 3,
Building Contractor
Address —�
Septic Tank Specifications: Length Width Depth Capacity__Gal.
Manufacturer's Name Address
No, of lines width in. Total Length ft. deo. of Sq. Ft.
Type of filter material Total tons used
Minimum Requirements: House Trailer 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:
Septic Tank Contractor
Note: Make sketbh of disposal system on back of sheet and mail to Health Center, Mocksville,
/VD � .
' Cl
U
��v X 3