P72067 Edgewood Cir DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
I. of Bedrooms � r,_ _ Date 2,
`rnis permit is granted to �sl �. t C r e e for the instal la ion of septic tank__
at the residence &ccQXe. Address
Building Contractor lav ; � :.,� k � Address /�/ ,
Setltic Tani: Specifications: Length Width/'''''_Depth_ ry Capacity Gal. n-a
Msnufacturer°s Name11 (> 5e��/ / �(!�t Address
No,, of. lines—1width � � i�n7_ Total Length. 99 ft. No. of Sq. Ft. 9D O
Type of falter material _776 r,/ Total tons used oZ�
Minimum Requirements: ---House-Trailer --'-,Tank Cap. 800 Sq. ft. dine - 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:
Sanitari
I hereby certify that the above ,septic tank,.has been Inst lled acco i . to cificatio
'Signe
d• - _
Septic Tank Contractor
Note: Make sketbh of disposal system on back `of.sheet and mail to Health Center, Mocksville.
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