P11867 Farmington Rd DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
Uo. of Bedrooms z Date Ili' 8
This permit is granted to`' ( for the installation of a septic tank--.
t the residence of .use Address 0 ,)-41
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal. !26 d
Manufacturer's Name Address
No. of lines r,-7 width in. Total Length ft. No. of Sq. Ft. 31-n
Type of filter material Total tons used '30
Mi.nimizm Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 800 6o0
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. r
Signed: �r
Septic Tank Contractor
Note: Make sketah-of disposal,-system on back: of sheet and mail to Health Center, Mocksville.
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