P72369 Edgewood Cir DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No. of Bedrooms o'�„!- Date 7 —023 Y
This permit is granted to e2, 77 eo • for the installation of a s ptic tank,..
at the residence of � �a�.r.�, Address
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Building Contractor _ Address
Septic Tann Specifications: Length Width Depth Capacity_ Gal.
Manufacturer's Name Address��
No.. of lines width!Kl/in. Total Length /S`O ft. No. of Sq. Ft. l0 0.0
Type of filter material' e _Total tons used \5-6
Minim-via Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-bedroom house 800 600
Three-bedroom house 900 900
No one shah 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 sketb1z of disposal system on back of sheet and mail to Health Center, Mocksville.
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