P92471 Hwy 801S DAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT
No of Bedrooms _d Date aZ _
This permit is granted o� C� for the int la i n o a eptic tank
at the residence of Address
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal. Om
Manufacturer's Name Address-- ' `3
No of lines_ width in. otal LengthO ft. No. of S Ft. �, a A
of
Type of filter material Total tons used 670
Minimum Requirements: House Tra' er Tank Cap. 800 - Sq. ft. line 1+00
Two--bedroom house 800 600
Three-bedroom house 900 900
No one shall install a septic tank in Davie County with out' a permit from the Health
Officer or his agent. x -
Date of final approval Signed: _
Sanitarian
I hereby certify that the above septic tank has been ins lled accordi to
specifications.
Signed:
Septic/Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
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