112 Dutchman Creek Rd Tragi to(z Nrr OL
DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
ilo, of Bedrooms '%�taLZO L- Date /D-93 -6
This permit is granted to 5S-�,,- %. C o for the installation of a septic tams..
at the residence of (fr� Address ,
Building Contractor _T Address
Septic Tank Specifications: Length Width Depth Capacity Gal. 900
Manufacturer's Name ''// Address
Plot of lines�_width {Xin. Total Length oo ft. No. of Sq. Ft. moo
Type of filter material -lo Total,tons used
44inimina 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 accord' g to s cifications.
Signed:
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center, Mocksville.
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DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
Do. of Bedrooms Date
This permit is granted to L%, ( for the installation of a septic tanit_
at the residence of ¢_ ��y�, Address ,
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal.
s
Manufacturer's Name c� 272, Addresser
No. of lineswidth '{Sfin. Total Length ob ft. No. of Sq. Ft.
Type of filter material to CZ,�,��e cr ,�,� Total tons used f
Minimum Requirements: House ;Trailer Tank Cap. 800 Sq. ft. line ' 1+00
Two-bedroom house 800 600
Three-bedroom house 900 goo
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 accord' g to s ecifications.
r Signed:
Septic Tank Contractor tr
1Note: Make sketch of disposal system on back of sheet and mail to Health Center, Mocksville -
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